**SHIFTS AVAILABLE ARE (4) 8A-5P, (4) 10A-7P, (7) 11A-8P EST M-F**

The Sr. Patient Navigator plays a critical role in ensuring patients have access to life-altering medications by supporting them through complex processes such as insurance verification, prior authorizations, and appeals. This position combines exceptional customer service, relationship management, and expertise in reimbursement practices to provide personalized support and ensure compliance with all healthcare regulations. The role also focuses on educating healthcare providers and patients on access, coverage, and reimbursement support. These roles will be regionally aligned to best support patients.

• Serves as the single point of contact and provides personalized case management for patients, caregivers, and healthcare providers (HCPs), including delivery of benefit investigations, prior authorization tracking, and appeal support.
• Educate patients, HCPs, and stakeholders on access and reimbursement processes, payer policies, and Valeris programs (e.g., patient assistance programs, copay programs).
• Build and maintain trusted relationships with patients, prescribers, and client stakeholders by delivering accurate, timely, and compassionate support.
• Coordinate and collaborate with client field teams, following agreed upon business rules and guidelines
• Communicate benefit coverage options and next steps in the patient journey using clear and patient-friendly language.
• Leverage electronic tools to navigate and complete benefit investigations, ensuring payer coverage is secured for prescribed treatments.
• Ensure all activities comply with healthcare laws, regulations, and Valeris standard operating procedures (e.g., HIPAA, insurance guidelines).
• Identify and escalate adverse events, product complaints, and special situation reports as required by the program.
• Document all activities in the Valeris system, maintaining detailed and accurate records.
• Support adherence services, including patient education and coordinating nurse teaching as applicable.
• Participate in team meetings and ongoing training to stay updated on policies and procedures.
• Travel required per client request

• Bachelor's degree required, preferably in healthcare administration, social science, or a related field.
• In lieu of a degree, candidates may qualify with:
• 5-10 years of relevant experience in areas such as insurance reimbursement, patient access, direct patient care, or patient education, or
• Relevant certifications (e.g., PACS, CHES, or CCM) plus at least 5 consecutive years of related experience.
• Minimum two (2) years of experience in healthcare access delivery or management is strongly preferred.
• Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
• Ability to prioritize tasks and work efficiently in a fast-paced environment
• Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.
• Bilingual / Multilingual is a plus