Specialty Pharmacy Liaison

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

📋 Description

• Act as the primary liaison for specialty pharmacies.

• Manage activities to ensure timely and accurate information transfer with network pharmacies.

• Monitor referral statuses.

• Address escalated issues and provide weekly updates to stakeholders.

• Recognize opportunities for process improvements.

• Provide outstanding patient experiences and maintain accurate medical records.

• Foster relationships with specialty pharmacies, patients, prescribers, and client stakeholders.

• Conduct post-Benefits Investigation calls to payors, patients, or physicians.

• Handle client and healthcare provider inquiries according to established business rules.

• Manage incoming calls from specialty pharmacy contacts and direct patients to appropriate resources.

• Carry out both electronic and manual benefits investigations.

• Clarify plan benefit coverage, prior authorizations, appeals, tier exceptions, and formulary exclusions.

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

• Coordinate nurse education and adherence service follow-ups.

• Identify peer-support resources.

• Monitor product shipments through patient assistance and bridge programs.

• Communicate needs for prior-authorization reverification and patient-assistance re-enrollment.

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

• Document actions in the Valeris Lynk system.

• Adhere to SOPs, complete corporate-policy training, and execute assigned tasks or projects.

⛳️ Requirements

• Bachelor’s degree in arts and sciences, social work, public health administration, or a related field is strongly preferred; equivalent experience is acceptable; a high school diploma or GED is required.

• Preferred experience includes 3 years in customer service, payer benefits (reimbursement, prior authorization, etc.), or the healthcare industry.

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

• Bilingual proficiency in English and Spanish is a plus.

• Strong attention to detail.

• Professional phone etiquette.

• Basic computer skills.

• Ability to effectively multitask.

• Clear and concise communication skills.

• Typing speed of at least 35 words per minute with 97% accuracy is preferred.

• Willingness to travel as necessary is preferred.

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

🏝️ Benefits

• 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 on Health Savings Accounts.

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

• Company-funded Short-Term Disability coverage, with an option to purchase Long-Term Disability.

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

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for career advancement and personal and professional development.

• A challenging and stimulating work environment that encourages innovative ideas.

• An inclusive workplace and mission-driven culture.

• Background check and, depending on the position, drug screening are required as conditions of employment.