Specialty Pharmacy Liaison

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and maintain trusted relationships with specialty pharmacies, patients, prescribers, and client stakeholders.

• Act as the primary contact for specialty pharmacies and manage all related activities.

• Ensure the prompt and precise transfer of information with network pharmacies.

• Follow up on the status of referrals.

• Resolve escalated issues effectively.

• Communicate weekly with stakeholders to identify opportunities for process enhancement.

• Conduct post Benefits Investigation calls to payors, patients, or physicians regarding coverage options.

• Handle client and healthcare provider inquiries in accordance with reporting and business regulations.

• Manage incoming calls from specialty pharmacy contacts.

• Direct patients to appropriate internal or external resources.

• Utilize electronic tools to identify benefits and payer coverage, and perform manual benefit investigations when necessary.

• Clearly communicate plan benefit coverage details, including prior authorization, appeals, tier exceptions, and formulary exclusions.

• Follow up with payers and specialty pharmacies on submissions and their outcomes.

• Organize nurse teaching and follow-up services.

• Identify peer support resources available for patients.

• Monitor and track product shipments through patient assistance or bridge programs.

• Communicate requirements for prior-authorization reverification or patient-assistance re-enrollment.

• Report adverse events, product complaints, special situation reports, and medical inquiries in compliance with SOPs and business rules.

• Document all activities in the Valeris Lynk system.

• Meet training deadlines and adhere to SOPs and corporate policies.

• Execute additional assigned tasks or projects.

⛳️ Requirements

• A Bachelor’s degree in arts and sciences, social work, public health administration, or a related field is strongly preferred, or equivalent experience is required.

• A high school diploma or GED is required.

• A minimum of 3 years’ experience in customer service, payer benefits, reimbursement, prior authorization, or the healthcare industry is preferred.

• Availability to work any 8.5-hour shift between 8 am and 9 pm, Monday to Friday.

• Bilingual proficiency in English and Spanish is a plus.

• Strong attention to detail.

• Professional telephone etiquette.

• Basic computer proficiency.

• Ability to effectively multitask.

• Capability to recognize emotions and their impacts.

• Commitment to maintaining honesty and integrity standards.

• Willingness to take responsibility for performance.

• Flexibility to adapt and manage change.

• Open-mindedness and willingness to embrace innovative ideas.

• Driven to achieve and committed to ongoing improvement.

• Alignment with organizational or group goals.

• Proactive in taking initiative and acting on opportunities.

• Maintain optimism and persistence in the face of challenges and setbacks.

• Service-oriented approach towards patients and care partners.

• Ability to communicate clearly and concisely.

• Positive attitude.

• Preferably able to type at least 35 words per minute with 97% accuracy.

• Flexibility to travel as required is preferred.

• Successful completion of a background check and, depending on the position, a drug screening is required.

🏝️ Benefits

• Comprehensive medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing to premium costs.

• Access to Telehealth and Employee Assistance Program (EAP) services.

• Company matching contributions for Health Savings Accounts.

• Complimentary Basic Life and AD&D insurance equal to annual earnings, with a minimum of $50,000 and a maximum of $300,000.

• Company-sponsored Short-Term Disability coverage, with the option to purchase Long-Term Disability insurance.

• 401(k) Retirement Savings Plan featuring a 100% match on the first 5% contributed, with immediate vesting.

• Paid Time Off (PTO) and Sick Leave benefits.

• Nine paid holidays along with two floating holidays.

• Opportunities for career advancement and personal as well as professional development.

• A challenging and stimulating work environment that fosters new ideas.

• An inclusive workplace with a mission-driven culture.

• The chance to make a meaningful impact through patient care and healthcare innovation.