Valisha Edwards

Increased patient access and provided reimbursement education for neurology, rare disease, and psychiatry programs.
Served as SME for regional and national insurance networks, specializing in prior authorization and appeals.
Gained direct experience with Buy and Bill products, Medicare Part B, and Miscellaneous J-Codes.
Educated and engaged healthcare providers, nurses, office champions, specialty pharmacies, closed-door pharmacies, HUB services, and foundation partners.
Achieved first place nationally for prior authorization metric pull-through.
Obtained CoverMyMeds certification; trained accounts and staff on platform utilization.
Facilitated education on clinical documentation, FDA-approved ICD-10-CM codes, and HCPCS billing practices.
Enhanced training sessions to improve understanding of reimbursement processes across diverse stakeholders.

Linked patients to essential mental health services, including medication and insurance programs.

Delivered behavioral health training to first responders to strengthen community integration.

Managed behavioral health crises while advocating for patients during acute interventions.

Led team in providing effective solutions during high-intensity situations, ensuring patient safety.

Coordinated psychosocial support for patients with end-stage renal disease, ensuring treatment continuity and medication management.

Collaborated with DaVita Specialty Pharmacy case managers to address reimbursement challenges and enhance patient access.

Facilitated communication among payers, dialysis clinics, infusion centers, and insurers to align resources effectively.

Orchestrated safe discharge planning with multidisciplinary teams, ensuring compliance with insurance requirements.

Secured prior authorizations for durable medical equipment and outpatient services to facilitate seamless transitions.

Streamlined post-discharge care by acting as an intermediary between clinical teams and insurance payers.

• Educated healthcare staff on payer structures and discharge implications for Medicare and commercial insurance.

Drove sales of cardiovascular products, achieving top representative rankings consistently.

Collaborated with key opinion leaders and specialists on product launches and educational programs.

Introduced a new drug to market through partnerships with clinical teams and provider networks.

Promoted novel therapies in pulmonology and rheumatology to enhance market presence.

Instructed healthcare providers on patient assistance programs and insurance access tools.

Surpassed sales targets consistently across all assigned therapeutic areas.

Launched a new drug, facilitating physician support for formulary access and payer alignment.