Patient Access Navigator

• Serve as the primary point of contact and case owner for patients and caregivers navigating insurance coverage, reimbursement, and access to therapy 
• Guide patients and HCP offices through benefits verification, prior authorization, appeals, and coverage requirements
• Proactively identify and resolve access barriers to minimize time-to-therapy and prevent treatment delays or abandonment
• Educate patients and caregivers on insurance coverage, financial responsibility, and available affordability or assistance programs using approved resources
• Monitor patient access milestones from referral through therapy initiation and continuation
• Deliver a high-touch, empathetic patient experience through personalized communication, active listening, and proactive follow-up
• Maintain long-term relationships with patients, caregivers, and HCPs throughout the treatment journey
• Support treatment continuation by addressing access-related challenges that arise over time
• Provide product and disease education focused on the treatment experience and access journey
• Collaborate closely with internal field teams, market access colleagues, safety, and compliance partners to ensure a coordinated and consistent patient experience
• Coordinate with HCP offices, specialty pharmacies, health insurance plans and external patient services vendors to resolve access, reimbursement, and logistical issues
• Conduct non-promotional on-site visits to HCP offices, when appropriate, to support complex patient access cases, clarify reimbursement requirements, or improve operational coordination related to patient access
• Communicate timely, clear updates to patients, caregivers, and HCPs regarding case status and next step
• Apply program business rules, standard operating procedures, and work instructions to deliver consistent, compliant, and high-touch patient services experience
• Document all patient interactions, access milestones, and case outcomes accurately within the Customer Relationship Management (CRM) system
• Maintain confidentiality of patient health information and ensure compliance with all applicable laws, regulations, and company policies, including HIPAA
• Ensure all interactions with HCP offices, including on-site engagements, are conducted in a non-promotional manner and in alignment with approved patient services scope and compliance guidance
• Support adverse event and product complaint reporting in accordance with established procedures
• Ability to travel up to 15% in each calendar year for customer or company meetings

Qualifications:

• Minimum of 5 years of experience in patient services, access navigation, reimbursement support, or case management within the healthcare or pharmaceutical/biotechnology industry
• Experience may include roles in patient access services, reimbursement support, case management, social work, or patient support programs
• Demonstrated expertise in private payer, Medicare Part D, and Medicaid reimbursement structures and processes
• Experience coordinating with patients, HCP offices, specialty pharmacies, health insurance plans and patient services vendors
• Proficiency with CRM systems (e.g., Salesforce) and ability to quickly learn internal workflows and systems
• Strong organizational skills with the ability to manage multiple patient cases and priorities simultaneously
• Excellent written and verbal communication skills with a patient-centered, empathetic approach
• Proficiency in Microsoft Excel, Word, and Outlook
• Oncology and/or rare disease experience
• Demonstrated success improving patient access outcomes, such as reducing time-to-therapy or treatment abandonment

Salary Range:

$170k - $200k USD