Valerie N. Myers
Charlotte,NC
Summary
Results-driven Quality and Training Manager with over 10 years of experience in pharmaceutical programs, including expertise in quality audits, prior authorizations, and appeals. Proven track record of success in developing and managing patient-focused, high-performance programs that meet and exceed goals. Possesses extensive knowledge of payer trends, reimbursement, and patient assistance programs, with over 10 years of experience in these areas. Skilled in collaborating with cross-functional teams and external stakeholders to drive program success and improve patient outcomes. Knowledge and experience in quality audits, trainings, government and private payer policies, appeals, prior authorizations through cover my meds, reimbursement processes, health policy, coverage, payment, coding, and Specialty Pharmacy processes.
Overview
13
13
years of professional experience
Work History
Program Access Manager
Occam Health Services
11.2024 - Current
- Support the entire reimbursement journey from patient enrollment or initiation, access determination, payer prior authorization to appeals/denials requirements procedures.
- Educate HCP’s and office staff on available patient assistance programs and explain the importance of their role in facilitating access to therapy for appropriate, eligible patients via communication both in person and virtual.
- Serve as payer and pharmacy expert for defined geography and proactively communicates changes to key stakeholders, both internal and external, in a timely manner. Coordinate with other patient service, market access and field personnel where appropriate.
- Coordinate with other patient services, market access and field personnel where appropriate. Identifies market access trends from local, regional, or national payers in assigned geography, and partners with internal and client teams to enable appropriate patient access and/or support patient pull-through programs.
- Maintain and grow knowledge of national, regional, local and account market dynamics including coverage and prior authorization requirements.
- On behalf of Ardelyx
Quality and Training Manager
IQVIA
03.2022 - 11.2024
- Headed up new launch for the program by creating SOP’s and Work Instructions.
- Created Quality Scorecards for multiple programs.
- Created job aides, power points, and training guides for copays, accumulators, maximizers, prior authorizations, and appeals.
- Established and maintained training that incorporated strategic thinking, including the use of technology that recommended solutions to both patients and providers, and identified project issues, resource gaps, and escalations to facilitate resolution.
- Responsible for presentation of quality metrics including program specific based training to both internal and external stakeholders.
- Identify, execute or delegate improvement of program processes by gathering information on the effectiveness of the program.
- Collect and interpret quality metrics.
- Maintain program and team performance by ensuring compliance and scorecards metrics were met.
- Proven track record of building and maintaining strong relationships with clients, including regular communication, anticipating and addressing their needs, and delivering excellent service.
Special Project Liaison
AmerisourceBergen - Lash Group
07.2012 - 03.2022
- Facilitated effective communication and collaboration among cross-departmental teams, clients, and third parties to ensure program success.
- Performed UAT’s in the Provider Portal and Fusion System (CRM).
- Proactively identified project issues, resource gaps, and escalations, and determined the best allocation of resources based on project priorities to facilitate resolution.
- Successfully assisting in launching and maintaining patient HUB/data touchpoints, including websites and customer relationship management tools.
- Created Annual Reverification training decks, schedules, and incentives for the multiple years
Education
B.S - Healthcare Leadership & Development
Cabarrus College
Concord, NC05.2026
A.A.S - Account & Business Administration
Surry Community College
Dobson, NC06.1998
Skills
- Quality and Training Management
- Leading Successful Program Launches
- Extensive experience in managing multiple patient CRM's
- Microsoft Office Suite
- Proven track record of building and maintaining strong relationships with clients
- Audit and compliance
- Effective written and verbal communication
- HIPAA compliance
- Effective problem solving
- Team management
- Insurance verification
- Strong leadership
- Patient education and counseling
Timeline
Program Access Manager
Occam Health Services
11.2024 - Current
Quality and Training Manager
IQVIA
03.2022 - 11.2024
Special Project Liaison
AmerisourceBergen - Lash Group
07.2012 - 03.2022
A.A.S - Account & Business Administration
Surry Community College
B.S - Healthcare Leadership & Development
Cabarrus College