Position Summary
- Patient Navigator for a rare disease Patient Support Program, serving as primary liaison for patients, caregivers, and healthcare providers to ensure seamless experience from prescription to ongoing therapy.
- Provide inbound/outbound phone support; coordinate with specialty pharmacy and reimbursement specialists to ensure timely medication access and refills.
Responsibilities
- Primary point of contact; provide non-clinical guidance and emotional support; understand disease state and product profiles.
- Explain eligibility, enrollment, reimbursement, affordability support, and access for prescribed therapies.
- Coordinate care among prescribers, specialty pharmacies, and insurance; monitor cases for delays (PA/benefit revalidation/refills) and proactively resolve.
- Educate patients/families on program resources, refill schedules, financial assistance.
- Partner with market access/reimbursement/specialty pharmacy teams to resolve coverage/dispensing challenges.
- Support onboarding, therapy continuation, and adherence initiatives aligned to KPIs.
- Verify insurance coverage and explain benefits across payer types (commercial and government programs).
- Handle reimbursement/co-pay/foundation assistance/PAP issues; communicate benefit investigations, PA/appeals requirements, and triage per SOPs.
- Review enrollment forms for data integrity; escalate complex cases per policy/SOPs.
- Document in case management/CRM systems; assist with PA/appeals; maintain privacy/confidentiality and compliant documentation.
Qualifications
- BA/BS (highly desired).
- RN/LPN/LVN/BSW/PharmD/RPh or equivalent; CPhT or CCM preferred.
- 5+ years in patient navigation, specialty pharmacy, case management, or patient access (rare disease/oncology/cell-gene highly preferred).
- Strong experience with benefits verification, prior authorization, and reimbursement.
- Exceptional communication, organization, problem-solving; empathetic, patient-centered.
- CRM/case tracking experience (Salesforce Health Cloud preferred); computer literacy (MS Office); ability to travel ~10% (possibly weekends).
Location
- Foster City, CA; must reside to comply with hybrid work policy.
Compensation
- Salary range: $125,000β$140,000 (base salary only; other compensation/benefits only if otherwise provided in posting).