The Patient Support Clinical Quality Analyst is responsible for reviewing and evaluating the performance of the clinical team members in their documentation, phone calls, and virtual trainings that represent Mercalis Market Access programs. The role requires a constructive, impartial, and collaborative approach, establishing positive work relationships with Market Access Leadership, Training, and Client teams. Demonstrating professionalism and expertise in an ever‑changing environment, the analyst gains the confidence and trust of others.
Responsibilities
* Review and evaluate the performance of clinical team members on telephonic, written, and video conferences using an approved quality scorecard to ensure adherence to the following:
o Medication package insert
o Evidence‑based disease state information
o Federal and Drug Administration (FDA) regulations of Adverse Events (AE)/Product Complaints (PC)
o Health Insurance Portability and Accountability Act (HIPAA) compliance
o Specific program policies and procedures (e.g., Business Rules Document)
* Analyze clinical calls and video conferences to determine trends and work with internal departments to develop solutions to improve the patient experience.
* Maintain a thorough understanding of company Standard Operating Procedures (SOPs), processes, and policy requirements.
* Prepare and analyze internal quality reports for clinical management staff.
* Participate with clinical leadership to establish and maintain clinical competencies for Market Access Programs.
* Manage disputes and call requests received through the ServiceNow portal.
* Participate and/or facilitate internal and external calibrations to identify client needs and expectations.
* Facilitate new‑hire training and introduce program quality standards and expectations.
* Prepare call records and/or corresponding documents and participate in internal and external client audits.
* Handle requests to locate specific call records from the call‑recording system, provide reports of findings, and edit call recordings to remove Protected Health Information as requested or according to contractual agreements.
* Participate in internal department meetings as needed.
* Contribute to the design of clinical call and video conferencing monitoring formats and quality standards.
* Identify and report pharmacovigilance information as required by client(s), e.g., Adverse Events.
* Ensure all SOPs are followed with consistency.
* Conduct miscellaneous tasks or projects as assigned.
Qualifications
* Licensed Practical Nurse (LPN), Diploma, Associate, or Bachelor’s degree in Nursing (BSN, RN) with a valid registered and active nursing license in one or more states.
* Minimum of 2 years of QA/QC or clinical safety and healthcare experience.
* Recommended 2–3 years of reimbursement/insurance, healthcare billing, physician office or health insurance processing experience.
* Ability to learn and maintain knowledge of medication package insert, FDA regulations of AE/PC, and HIPAA guidelines.
* Motivated self‑starter with the ability to work independently and cooperatively within a cross‑functional environment.
* Capable of managing priorities while working independently without direct supervision, maintaining a high level of professionalism and integrity.
* Flexible and willing to respond to changing circumstances and expectations readily.
* Problem‑solving and independent decision‑making skills with confidence.
* Ability to collect, gather, visualize, and analyze data in detail.
* Fair and impartial.
* Displays a high level of professionalism, integrity, maturity, and a positive attitude.
* Excellent verbal and written communication and interpersonal skills.
* Strong planning, time‑management, attention to detail, and organizational skills.
* Comfortable interacting with all levels of management and personalities.
* Basic knowledge of MS Office (Word, Excel).
* Basic knowledge of monitoring software preferred (e.g., Zoom Call Recording, Calabrio, NICE Call Recording).
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, type, handle or feel, and reach with hands and arms. Preference is given to candidates who can type at least 35 words per minute with 97% accuracy.
* Minimal flexibility to travel as needed is preferred.
* This job operates in a professional office environment and 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 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.
* 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.
* 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.
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards.
Our Commitment to Equal Opportunity
At Valeris, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.
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