Patient Navigator

Role Summary

Patient Navigator

Are you someone who has the proven ability to thrive in a dynamic, evolving environment and contribute to building new capabilities in healthcare. We’re seeking an empathetic, detail-driven Patient Navigator to join our growing rare disease team. In this pivotal role, you’ll serve as the primary liaison for patients, caregivers, and healthcare providers, ensuring a seamless experience from prescription to ongoing therapy. You will provide inbound and outbound phone support and serve as the primary contact for patients, caregivers, and providers. You will facilitate a collaborative process that gauges, coordinates, and monitors patient need and appropriately facilitates a patient’s journey utilizing services offered through the Patient Support Program on behalf of Mirum and coordination with our specialty pharmacy partner. You’ll work closely with the specialty pharmacy, reimbursement specialists, and internal partners to make sure patients receive their medications on time, every time. The outcome of your efforts will be to provide unparalleled customer service to patients, caregivers and providers.

If you have a nursing or case management background, you can thrive in a fast-paced biotech environment and are passionate about helping patients with rare diseases navigate complex access barriers—this is the opportunity for you.

Responsibilities

• Serve as the main point of contact for patients and caregivers, providing non-clinical guidance and emotional support throughout their treatment journey demonstrating a thorough understanding of the disease state and Mirum product profiles.
• Provide patients and HCPs a clear understanding of eligibility requirements, program enrollment, reimbursement process, affordability support, and general access for Mirum prescribed therapies.
• Deliver unparalleled customer service while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commit to the appropriate use of resources
• Coordinate care between prescribers, specialty pharmacies, and insurance providers to ensure timely drug access and refills.
• Monitor patient cases to identify potential delays or issues (e.g., prior authorizations, benefit revalidations, prescription renewals) and proactively resolve them.
• Educate patients and families about program resources, refill schedules, and financial assistance options.
• Elevate the patient experience by partnering with Mirum‚Äôs market access, reimbursement, and specialty pharmacy teams to resolve coverage and dispensing challenges.
• Support patient onboarding, therapy continuation, and adherence initiatives in alignment with program KPIs.
• Serve as a resource for patients and healthcare professionals to verify insurance coverage, reimbursement process, and general access for complex pharmaceuticals and ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD)
• Patient Navigators will be regionally aligned and will serve as an expert on reimbursement, co-pay, foundation assistance, patient assistance program (PAP) issues, and other forms of available support and will be responsible for handling patient and healthcare provider interactions related to these topics in collaboration with the Regional Access Leads and Regional Account Managers.
• Responsible for communicating insurance benefit investigations, prior authorization and appeal requirements, and triage cases according to program standard operating procedures
• Serve as direct point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient
• Evaluate program enrollment forms for data integrity and missing information
• Follow program guidelines and escalate complex cases according to program policy, SOPs, Call Guides, and other program materials.
• Working in a case management system, documenting status/background in case notes, communicating patient benefits, assisting in the PA/Appeals process and like responsibilities
• Act as an assigned liaison to customer contacts (e.g., regional contact for sales representatives), Market Access colleagues, other internal stakeholders and healthcare providers
• Works with the Program Supervisor, on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction and program effectiveness
• Maintains a high level of ethical conduct regarding confidentiality and privacy.
• Help maintain team morale by consistently demonstrating positive attitude.
• Maintain accurate, compliant documentation within CRM and case management systems.
• Conducts miscellaneous tasks or projects as assigned identify and report pharmacovigilance information as required, i.e., Adverse Events, and Product Quality Complaints

Qualifications

• BA/BS Highly Desired.
• Registered Nurse (RN), Licensed Practical Nurse (LPN/LVN) Social Worker (BSW), or Case Manager (CCM) preferred.
• Minimum 5+ years of experience in patient navigation, specialty pharmacy, case management, or patient access preferably in biotech, rare disease, oncology or cell/gene therapy.
• Strong understanding and experience in working through benefits verification, prior authorization, and reimbursement processes.
• Exceptional communication, organization, and problem-solving skills that have been demonstrated in producing improved patient experiences and outcomes.
• Proven ability to work independently in a high-volume, fast paced and patient-focused environment.
• Empathetic and patient-centered mindset with a commitment to improving rare disease care.
• Ability to multitask and balance multiple priorities at once.
• Demonstrated ability to deliver meaningful & concise conversations with integrity and empathy directly to patients and health care providers
• Experience using CRM or case tracking systems (Salesforce Health Cloud preferred)
• In-depth understanding of health insurance benefits, relevant state and federal laws and insurance regulations.
• Excellent written and oral communication, and problem-solving skills, including the ability to connect with patients, caregivers, and providers.
• Experience and demonstrated success working in a complex matrix to accomplish goals with a patient centric approach.
• Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust.
• Robust computer literacy skills including data entry and MS Office-based software programs.
• Possesses strong business acumen and strategic thinking skills.
• Ability to identify and handle sensitive issues, working independently and collaboratively within teams.
• Ability to travel required, ~10%, possibly weekends.
• This position is based in Foster City, CA or Charlotte, NC. Applicants must reside in a location which would allow them to comply with Mirum‚Äôs hybrid work policy.

Education

• Not specified