Position Summary
Empathetic, detail-driven Patient Navigator to serve as the primary liaison for patients, caregivers, and healthcare providers, ensuring a seamless experience from prescription to ongoing therapy.
Responsibilities
- Serve as main point of contact for patients/caregivers; provide non-clinical guidance and emotional support.
- Explain eligibility, program enrollment, reimbursement, affordability support, and access for Mirum therapies.
- Provide customer service as a brand advocate; support quality outcomes.
- Coordinate with prescribers, specialty pharmacies, and insurance providers for timely access and refills.
- Monitor cases for delays/issues (prior authorizations, benefit revalidations, renewals) and proactively resolve.
- Educate patients/families on program resources, refill schedules, and financial assistance.
- Partner with market access, reimbursement, and specialty pharmacy teams to resolve coverage/dispensing challenges.
- Support onboarding, therapy continuation, and adherence initiatives aligned to KPIs.
- Verify insurance coverage and benefits across payer types (private/commercial and government: Medicare/Medicaid/VA/DOD).
- Serve as expert for reimbursement, co-pay/foundation assistance, and PAP issues; handle related interactions.
- Communicate benefit investigations, prior authorization/appeal requirements, and triage per SOPs.
- Point of contact for HCPs; share detailed program/patient information.
- Evaluate enrollment forms for completeness; follow guidelines and escalate complex cases.
- Document in CRM/case systems; assist with PA/appeals.
- Act as liaison to regional contacts, Market Access, stakeholders, and HCPs.
- Maintain confidentiality; maintain accurate, compliant documentation.
- Identify/report pharmacovigilance info (adverse events, product quality complaints) as required.
Qualifications
- BA/BS highly desired.
- Bilingual in English & Spanish (required).
- RN/LPN/LVN, Social Worker (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 preferred).
- Strong benefits verification, prior authorization, and reimbursement experience.
- Exceptional communication, organization, problem-solving; works independently in fast-paced environments.
- CRM/case tracking experience (Salesforce Health Cloud preferred).
- In-depth knowledge of insurance benefits and relevant laws/regulations.
- Strong computer literacy (data entry, MS Office).
- Ability to travel ~10% (possibly weekends).
- Based in Charlotte, NC; must reside to comply with hybrid work policy.
Application instructions
- Applicants must reside in a location that allows compliance with Mirumβs hybrid work policy.