Patient Navigator

Role Summary

The Patient Navigator is a key member of Mirum’s rare disease team. You will act as the primary liaison for patients, caregivers, and healthcare providers, guiding the patient from prescription through ongoing therapy. You will provide inbound and outbound support and coordinate with the Patient Support Program, the specialty pharmacy partner, and internal teams to ensure timely access and high-quality service. A nursing or case-management background is preferred to help patients navigate complex access barriers. This role is based in Foster City, CA or Charlotte, NC, with travel up to 10% (including weekends).

Responsibilities

• Serve as the main point of contact for patients and caregivers, providing non-clinical guidance and emotional support throughout their treatment journey, with 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 outstanding customer service while serving as brand advocate and program representative, understanding the importance of achieving quality outcomes and committing 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’s 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).
• Regionally aligned Navigators will serve as experts on reimbursement, co-pay, foundation assistance, patient assistance program (PAP) issues, and will handle interactions related to these topics in collaboration with Regional Access Leads and Regional Account Managers.
• Communicate insurance benefit investigations, prior authorization and appeal requirements, and triage cases according to program SOPs.
• Serve as direct point of contact to health care providers for ongoing support and relationship development by 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.
• Work in a case management system, document status/background in case notes, communicate patient benefits, and assist in the PA/Appeals process.
• Act as an assigned liaison to customer contacts (e.g., regional contact for sales representatives), Market Access colleagues, and other internal stakeholders and healthcare providers.
• Collaborate with the Program Supervisor to maintain open lines of communication regarding patient status, prescriber feedback, and program effectiveness.
• Maintain a high level of ethical conduct regarding confidentiality and privacy.
• Support team morale by demonstrating a positive attitude.
• Maintain accurate, compliant documentation within CRM and case management systems.
• Conduct miscellaneous tasks or projects as assigned and identify and report pharmacovigilance information as required (e.g., Adverse Events, Product Quality Complaints).

Qualifications

• Required: Minimum 5+ years of experience in patient navigation, specialty pharmacy, case management, or patient access.
• Preferred: RN, LPN/LVN, Social Worker (BSW), or Case Manager (CCM).
• Required: Strong understanding of benefits verification, prior authorization, and reimbursement processes.
• Required: Exceptional communication, organization, and problem-solving skills with a track record of improving patient experiences and outcomes.
• Required: Ability to work independently in a high-volume, fast-paced, patient-focused environment.
• Required: Empathetic, patient-centered mindset with a commitment to improving rare disease care.
• Required: Ability to multitask and balance multiple priorities.
• Required: Ability to deliver meaningful and concise conversations with integrity and empathy to patients and healthcare providers.
• Preferred: Experience using CRM or case tracking systems; Salesforce Health Cloud preferred.
• Required: In-depth understanding of health insurance benefits, and relevant state and federal laws and regulations.
• Required: Excellent written and oral communication and problem-solving skills, including the ability to connect with patients, caregivers, and providers.
• Required: Experience and success working in a complex matrix to accomplish goals with a patient-centric approach.
• Required: Strong interpersonal skills with flexibility, persistence, creativity, empathy, and trust.
• Required: Robust computer literacy including data entry and MS Office.
• Required: Strong business acumen and strategic thinking skills.
• Required: Ability to identify and handle sensitive issues, working independently and collaboratively within teams.

Education

• BA/BS Highly Desired.

Additional Requirements

• Travel: Ability to travel up to ~10%, possibly including weekends.
• Location: Based in Foster City, CA or Charlotte, NC; applicants must reside in a location that allows compliance with Mirum’s hybrid work policy.