Specialty Pharmacy Liaison
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Job Description
Specialty Pharmacy Account Liaison supporting patient access to complex medications. Managing pharmacy communications, benefits investigations, referrals, and adherence services for Valeris healthcare programs.
Responsibilities:
- Serve as a central point of contact for specialty pharmacies
- Own activities and ensure timely, accurate information transfer with network pharmacies
- Follow up on referral status
- Resolve escalated issues and communicate weekly with stakeholders
- Identify process improvement opportunities
- Deliver exceptional patient experiences and manage medical records accurately
- Build relationships with specialty pharmacies, patients, prescribers, and client stakeholders
- Make post-Benefits Investigation calls to payors, patients, or physicians
- Manage client and HCP inquiries according to business rules
- Manage inbound calls from specialty pharmacy contacts and triage patients to resources
- Perform electronic and manual benefits investigations
- Explain plan benefit coverage, prior authorization, appeals, tier exceptions, and formulary exclusions
- Follow up with payers and specialty pharmacies on submissions and outcomes
- Coordinate nurse teaching and adherence-service follow-up
- Identify peer-support resources
- Track product shipments through patient assistance and bridge programs
- Communicate prior-authorization reverification and patient-assistance re-enrollment needs
- Report adverse events, product complaints, special situation reports, and medical inquiries according to SOPs
- Document activities in the Valeris Lynk system
- Follow SOPs, complete corporate-policy training, and perform assigned tasks or projects
Requirements:
- Bachelor’s degree in arts and sciences, social work, public health administration or a related field strongly preferred, or equivalent experience; high school diploma or GED required
- 3 years’ customer service, payer benefits (reimbursement, prior authorization, etc.), or healthcare industry experience preferred
- Ability to work any 8.5-hour shift between 8 am and 9 pm, Monday to Friday
- Bilingual in English and Spanish is a plus
- Detail oriented
- Professional telephone etiquette
- Basic computer knowledge
- Ability to multitask effectively
- Clear and concise communication
- Type at least 35 words per minute with 97% accuracy preferred
- Flexibility to travel as needed preferred
- Successful completion of a background check and, depending on the position, a drug screen
Benefits:
- Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
- Telehealth and Employee Assistance Program (EAP) services
- Company match on Health Savings Account contributions
- Free Basic Life and AD&D coverage equal to 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% contributed, with immediate vesting
- Paid Time Off (PTO) and Sick Leave
- Nine paid holidays plus two floating holidays
- Opportunities for advancement and personal and professional growth
- Challenging, stimulating work environment that encourages new ideas
- Inclusive workplace and mission-driven culture
- Background check and, depending on the position, drug screen are required as employment contingencies
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