[Hiring] Patient Engagement Specialist @Valeris

Role Description

The 9:30 AM - 6 PM ET shift is required for this role.

• Build and maintain trusted relationships with patients by demonstrating proactive communication, delivering timely and accurate services, and showing a strong commitment to patient well-being.
• Ensure all interactions and relationship management practices comply with relevant healthcare laws and regulations.
• Demonstrate prior experience working with pharmacy benefit products and patients, or in immunology practices, to better understand patient needs and concerns.
• Conduct program welcome calls to patients, engaging them effectively and explaining available services and resources for their support.
• Utilize motivational interviewing techniques to actively involve patients in goal setting and achieving their healthcare objectives.
• Perform post Benefits Investigation calls to patients, clearly explaining coverage options to enhance patient understanding.
• Effectively handle all client inquiries that cannot be resolved through standard reporting processes.
• Address patient inquiries in accordance with applicable business rules, providing accurate and helpful information.
• Articulate complex reimbursement and billing information in a clear and concise manner to ensure patients comprehend their coverage benefits and financial responsibilities.
• Handle inbound calls as per the program-approved Frequently Asked Questions (FAQs).
• Exhibit excellent customer service skills, even in a fast-paced environment, and de-escalate any challenging situations in a professional and appropriate manner.
• Triage patients to appropriate internal or external resources, depending on their needs and requirements.
• Ensure proper documentation and recording of patient enrollment into the program, following established business rules.
• Provide patients with comprehensive information and education about products, including the course of treatment, insurance coverage benefits, anticipated out-of-pocket costs, potential financial assistance resources, and ongoing treatment support.
• Proactively manage assigned cases and tasks to maintain service levels and deliver excellent customer service to patients.
• Empower and inspire patients to take charge of their therapy plan as prescribed by their healthcare provider.
• Leverage electronic tools to identify benefits and payer coverage, conducting manual benefit investigations when necessary.
• Identify and communicate patients' plan benefit coverage, including any prior authorization, appeal, tier exception, or formulary exclusion requirements.
• Utilize electronic resources to obtain benefit coverage outcomes, and if needed, conduct outbound calls to payers and healthcare providers for follow-up.
• Support adherence services through the coordination of nurse follow-up, as applicable to the program.
• Identify and recommend peer support resources for patients to enhance their treatment experience.
• Coordinate the shipment of products through patient assistance programs and/or bridge programs from the PharmaCord pharmacy.
• Proactively communicate the need for re-verification of prior authorization or re-enrollment for patient assistance programs.
• Report adverse events, product complaints, special situation reports, and medical inquiries in accordance with established SOPs and Business Rules.
• Document all activities within the Lynk system to maintain accurate and up-to-date records, adhering to business requirements.

Qualifications

• Bachelor's degree strongly preferred or equivalent experience required; completion of a high school diploma or GED is required.
• Customer service and healthcare industry experience strongly preferred.
• Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday required.
• Bi-lingual in English and Spanish or Chinese/Mandarin is a plus.
• Commitment to the mission of care coordination.
• Passionate, trustworthy, and empathetic when working with patients.
• Good communication and interpersonal skills and ability to speak concisely to patients.
• Flexible and adaptable in response to changing patient and healthcare providers’ needs.
• Professional telephone etiquette.
• Self-awareness of your own emotions and the potential impact on others.
• Basic computer knowledge.
• Ability to multitask effectively.
• Ability to recognize emotions and their effects.
• Sureness about self-worth and capabilities.
• Manage disruptive impulses.
• Maintain standards of honesty and integrity.
• Takes responsibility for performance.
• Adapts and handles change with flexibility.
• Is innovative and open to new ideas.
• Achievement driven; constantly striving to improve or to meet a standard of excellence.
• Aligns with the goals of the group or organization.
• Ready to take initiative and act on opportunities.
• Be optimistic and pursue goals persistently despite obstacles and setbacks.
• Be service oriented and anticipate, recognize and meet the needs of others, including patients and care partners.
• Positive attitude!

Physical Demands & Work Environment

• While performing the duties of this job, the employee is regularly required to talk or hear.
• The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms.
• Prefer candidates who can type at least 35 words per minute with 97% accuracy.
• Although very minimal, flexibility to travel as needed is preferred.
• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.

Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs.
• Additional health support, including telehealth and Employee Assistance Program (EAP) services.
• Company match on Health Savings Account contributions.
• Free Basic Life and AD&D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000.
• Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability.
• 401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting.
• Paid Time Off (PTO) and Sick Leave to support work-life balance.
• Team members receive nine paid holidays plus two floating holidays.
• Opportunities for advancement in a company that supports personal and professional growth.
• A challenging, stimulating work environment that encourages new ideas.
• Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace.
• A mission-driven, inclusive culture where your work makes a meaningful impact.