Patient Navigator - Bilingual

Role Summary

Patient Navigator to join the rare disease team. Serve as the primary liaison for patients, caregivers, and healthcare providers, ensuring a seamless experience from prescription to ongoing therapy. Provide inbound and outbound phone support and coordinate with the Patient Support Program and specialty pharmacy to ensure timely medication access.

Responsibilities

• Serve as the main point of contact for patients and caregivers, providing non-clinical guidance and emotional support throughout their treatment journey.
• Provide patients and healthcare providers a clear understanding of eligibility, program enrollment, reimbursement, affordability support, and general access for Mirum prescribed therapies.
• Deliver excellent customer service as a brand advocate and program representative; promote appropriate use of resources.
• Coordinate care between prescribers, specialty pharmacies, and insurance providers to ensure timely drug access and refills.
• Monitor patient cases for delays or issues (e.g., prior authorizations, benefit revalidations, renewals) and resolve them proactively.
• Educate patients and families about program resources, refill schedules, and financial assistance options.
• Collaborate with 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.
• Verify insurance coverage, reimbursement processes, and general access for complex pharmaceuticals; explain benefits across payer types.
• Operate as regionally aligned expert on reimbursement, co-pay, foundation assistance, PAP, and related support; collaborate with Regional Access Leads and Regional Account Managers.
• Communicate insurance benefit investigations, prior authorization and appeal requirements; triage cases per SOPs.
• Serve as direct point of contact to healthcare providers for ongoing support and relationship development with program information.
• Evaluate enrollment forms for data integrity and missing information.
• Follow program guidelines and escalate complex cases per policy, SOPs, and guides.
• Document status in case management systems; assist with PA/Appeals process and related responsibilities.
• Act as liaison to customers, Market Access colleagues, and other internal stakeholders and providers.
• Maintain open lines of communication with Program Supervisor; monitor patient status and program effectiveness.
• Maintain ethical confidentiality and privacy; contribute to team morale with a positive attitude.
• Maintain accurate, compliant documentation within CRM/case management systems.
• Contribute to miscellaneous tasks; report pharmacovigilance information (e.g., Adverse Events, 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 (biotech/rare disease preferred).
• Bilingual in English and Spanish required.
• Strong understanding of benefits verification, prior authorization, and reimbursement processes.
• Excellent communication, organization, and problem-solving skills with proven ability to improve patient experiences and outcomes.
• Ability to work independently in a high-volume, fast-paced, patient-focused environment.
• Empathetic, patient-centered mindset with commitment to improving rare disease care.
• Ability to multitask and balance multiple priorities; deliver concise, empathetic conversations with patients and providers.
• Experience using CRM or case tracking systems (Salesforce Health Cloud preferred).
• Understanding of health insurance benefits and relevant laws/regulations.
• Strong written and verbal communication and problem-solving skills; ability to connect with patients, caregivers, and providers.
• Experience working in a complex matrix to accomplish goals with a patient-centric approach.
• Strong interpersonal skills: flexibility, persistence, creativity, empathy, and trust.
• Proficient computer literacy including data entry and MS Office.
• Strong business acumen and strategic thinking.
• Ability to handle sensitive issues independently and collaboratively within teams.
• Ability to travel required, ~10%, possibly weekends.
• Based in Foster City, CA or Charlotte, NC; reside where able to comply with hybrid policy.

Education

• BA/BS degree preferred.

Additional Requirements

• Travel: ~10%, possibly weekends.
• Location: Foster City, CA or Charlotte, NC; hybrid work eligibility.