Patient Navigator (6:00 a.m. -3:00 p.m. MST or 9:00 a.m. - 6 p.m. EST)

JOB DESCRIPTION:

The Patient Navigator provides education and reimbursement/case management support for healthcare providers and patients.  From Intake to Outcome, Patient Navigators are dedicated to supporting healthcare providers and patients throughout the treatment journey by providing ongoing disease state and product education, case management, and adherence support to help limit barriers that may hinder appropriate patient outcomes.

POSITION SUMMARY:

Under the general supervision of the Novartis Patient Support Center Team Manager, the Patient Navigator is responsible for customer service, support, education, outreach, and case management. The Patient Navigator will work interactively with internal teams, patients, healthcare providers, pharmacies, and payers.  The Patient Navigator team will also support various reimbursement and patient assistance functions. The Patient Navigator will respond to all patient and customer/provider account inquiries.

This position does not involve the practice of nursing, provide clinical advice or counseling for the patient. Documents all interactions with the Novartis Patient Support Center are in compliance with HIPAA regulations.

PRIMARY DUTIES AND RESPONSIBILITIES:

• The Patient Navigator interacts directly with patients and/or their caregivers via telephonic support and acts as a single point of contact and voice for patients.
• Works as a patient advocate, demonstrates compassion and coordinates access to therapies, conducts appropriate follow up and facilitates access to appropriate support services
• Collects and review all patient information, to the degree authorized by the SOP of the program
• Validates completeness of all required information and provides assistance to provider and/or patient
• Provides guidance to physician office staff and patients on how to complete and submit all necessary program applications in a timely manner
• Provides exceptional customer service to internal and external customers; responds and resolves customer requests in a timely and accurate manner; escalates complaints accordingly
• Maintain frequent phone contact with patients, provider representatives, payer, third party customer service representatives and pharmacy staff
• Educates on support resources and information relating to Novartis therapies as prescribed by an HCP, including access offerings, disease state and relevant dosing/administration, treatment reminders within the established guidelines of approved call cadence guides and work instructions 
• Confirm patient eligibility according to approved work instruction within the CRM platform
• Responsible for ongoing management of primary caseload
• Provides payer education, reimbursement information, resources and support to providers and/or patients to support access to therapy. 
• Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)

• Maintain accurate and thorough documentation of all patient interactions, including adverse event reporting as required by corporate guidelines within the electronic CRM platform.
• Lead triage of daily caseload in Salesforce and assign to Navigator team
• Required to adhere to compliance guidelines as required by Novartis Pharmaceuticals and the Novartis Patient Navigator Program including Up4Growth, approved call guides and scripts, HIPAA guidelines and adverse event reporting
• Participate in ongoing training with Patient Navigator team on new and/or updated Program  information, i.e. work instructions, call guides, disease area, product specific content, Patient Navigator overall role and responsibilities as well as brand, call cadences, and compliance training
• Exhibit collaborative behaviors with external vendor teams to ensure seamless program/platform operations, enhance operational efficiencies, and ensure that all materials and activities are executed in full alignment with NPC and Patient Navigator standards with
• Exhibit collaborative behaviors with cross functional teams (Patient Services, Brand(s), Patient Safety, Legal, Compliance and Privacy) to ensure seamless program operations, enhanced operational efficiencies and reporting
• Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action
• Typically receives little instruction on day-to-day work, general instructions on new assignments
• Extensive knowledge of HIPAA regulations and follows all company policies
• Provides education and support for Risk Evaluation and Mitigation Strategy (REMS) Program requirements
• Perform related duties as assigned

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• Education: Bachelor’s degree and an active Nursing licensure (RN, NP, PA) in state in which candidate resides
• Previous 5+ years of experience in a specialty pharmacy, medical insurance, reimbursement hub experience, physician’s office, healthcare setting, and/or insurance background preferred
• 3+ years of experience working with Complex Specialty products in a pharmaceutical/healthcare setting required (such as Biologics, Medical Devices, Oncology, Transplant, Infusion, Rare Disease, etc.)
• Bachelor’s degree; Active Nursing Degree (RN, NP, PA) licensure in state in which you resides
• Knowledge of HIPAA regulations
• Knowledge of pharmacy benefits, and medical benefits
• Global understanding of commercial and government payers preferred
• Preferred Experience
  • Oncology/Rare Disease
  • Telemedicine/Contact Center/Patient Support
  • Risk Evaluation and Mitigation Strategy (REMS)

OTHER REQUIREMENTS:

• This job requires you live within 90 miles of the East Hanover or Tempe site of Novartis.
• Proximity and ability to commute to work onsite in East Hanover or Tempe as required by our hybrid model for occasional meetings or events.  To be scheduled at the discretion of the business.
• When working from home, a quiet dedicated space where the employee can work without interruption
• For Patient Support Center (PSC) Roles with a Dedicated Training Period: The individual hired for this role will be required to successfully complete initial training, including passing simulations and become certified to do the role.