Patient Navigator

Role Summary

Patient Navigator at Mirum Pharmaceuticals. Serve as the primary liaison for patients, caregivers, and healthcare providers, ensuring a seamless experience from prescription to ongoing therapy. Provide inbound and outbound support, coordinate with specialty pharmacy and internal partners to ensure timely access to medications, and deliver high-quality customer service within a rare disease-focused program.

Responsibilities

• Serve as the main point of contact for patients and caregivers, providing non-clinical guidance and emotional support throughout their treatment journey with knowledge of disease state and Mirum product profiles.
• Explain eligibility requirements, program enrollment, reimbursement processes, affordability support, and general access for Mirum therapies.
• Deliver exceptional customer service while acting as a brand advocate and program representative; use resources appropriately to achieve quality outcomes.
• 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, prescriptions) and proactively resolve them.
• 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 aligned with program KPIs.
• Verify insurance coverage, reimbursement processes, and general access for complex therapies; explain benefits across payer types including private, government programs.
• Operate regionally with expertise in reimbursement, co-pay, foundation assistance, and patient assistance programs in collaboration with Regional Access Leads and Regional Account Managers.
• Communicate insurance benefit investigations, prior authorization and appeal requirements; triage cases per SOPs.
• Serve as a direct contact to healthcare providers for ongoing support and relationship development; provide detailed program/patient information.
• Evaluate enrollment forms for data integrity and missing information; follow guidelines and escalate complex cases per policies.
• Document status and background in case notes; support PA/Appeals process and related responsibilities in a case management system.
• Act as liaison to customers, regional sales, Market Access colleagues, internal stakeholders, and healthcare providers.
• Maintain open lines of communication with Program Supervisor; monitor patient status, prescriber feedback, and program effectiveness.
• Maintain confidentiality and privacy; support team morale and positive attitude.
• Maintain accurate, compliant documentation within CRM and case management systems.
• Contribute to miscellaneous tasks or projects and report pharmacovigilance information as required (e.g., Adverse Events, Product Quality Complaints).

Qualifications

• BA/BS strongly 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 of benefits verification, prior authorization, and reimbursement processes.
• Excellent communication, organization, and problem-solving skills; 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.
• Proven ability to have meaningful and concise conversations with patients and health care providers with integrity and empathy.
• Experience using CRM or case tracking systems (Salesforce Health Cloud preferred).
• Strong understanding of health insurance benefits, including relevant laws and regulations.
• Excellent written and oral communication and problem-solving skills; ability to connect with patients, caregivers, and providers.
• Experience working in a complex matrix to achieve 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 and work independently and with teams.
• Ability to travel approximately 10%, possibly on weekends.
• Based in Foster City, CA or Charlotte, NC; reside in a location that complies with Mirum’s hybrid work policy.

Education

• BA/BS preferred; additional nursing, social work, or case management credentials beneficial.

Additional Requirements

• Ability to travel ~10%; weekend travel may be required.
• Hybrid work policy compliance required.