Nurse Navigator

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with healthcare providers, specialty pharmacies, and payers to ensure patients have access to their prescribed medications, comprehend cost support options, understand educational materials, and receive tailored support throughout their treatment journey.

• Act as the main point of contact for patients and caregivers who have been prescribed medication, offering personalized assistance on their treatment path.

• Serve as a contact for healthcare professionals (HCPs) to provide support for enrollments into patient support programs.

• Assist patients and/or caregivers with the post-prescription process, including enrollment in support programs, benefits verification, prior authorization, financial aid, and therapy initiation.

• Educate patients on program offerings, insurance processes, disease states, and treatments using approved materials.

• Oversee assigned patient cases from referral to therapy initiation, ensuring timely, accurate, and compliant case management.

• Conduct benefits investigations to determine insurance coverage, prior authorization requirements, and patient financial responsibilities.

• Manage the prior authorization and appeals processes, including obtaining plan-specific criteria and requirements, initiating, submitting, and tracking requests, and following up with plans, patients, and HCPs as needed to ensure timely outcomes.

• Proactively identify and resolve barriers to therapy, including financial, clinical, and adherence challenges.

• Support medication adherence and ongoing patient engagement through a series of interactions.

• Coordinate with providers, pharmacies, and internal teams to ensure seamless care delivery.

• Document all patient interactions and outcomes in line with program requirements.

• Monitor case progress and escalate complex reimbursement issues as necessary.

• Engage in quality initiatives, audits, and continuous improvement efforts.

• Ensure adherence to all regulatory and privacy standards.

⛳️ Requirements

• An active, unrestricted RN license is required.

• A minimum of 3 years of clinical nursing experience.

• Over 3 years of experience in dermatology or immunology is preferred.

• 2 to 5 years of case management and patient support experience is required.

• Experience in case management, patient access, HUB services, or specialty pharmacy is preferred.

• A solid understanding of healthcare systems and patient advocacy is essential.

• Excellent communication and interpersonal skills are necessary.

• Ability to independently manage a patient caseload.

• Strong organizational and problem-solving abilities are required.

• Comfortable working in a virtual or call center environment.

🏝️ Benefits

• Competitive compensation that acknowledges your experience, expertise, and contributions.

• Comprehensive benefits including medical, dental, and vision coverage; accrued paid time off; 401(k) with company match; disability and life insurance; and paid maternity and paternity leave.

• Company-paid holidays to help you rest, recharge, and focus on what matters most.

• Recognition programs, contests, and awards that celebrate your contributions.

• Continuous growth opportunities through learning, leadership development, and career advancement support.

• A collaborative culture where your ideas are appreciated, and your work has a meaningful impact.