Drug Access Navigator

Highlands Oncology Group; Springdale (AR); On-site; USD 42,000 - 68,000; Full time

Job summary

Highlands Oncology Group seeks a Drug Access Navigator to manage prior authorizations, financial assistance, and medication access for cancer therapies. You will collaborate with physicians, clinical staff, and insurers to secure timely approvals and minimize patient costs.

The role requires strong knowledge of insurance processes, oncology treatments, and effective communication. You will build relationships across departments to ensure seamless patient care within our Northwest Arkansas

Qualifications

• Experience with prior authorizations for specialty and non-specialty medications.
• Knowledge of insurance processes and oncology treatments.
• Ability to obtain financial assistance and navigate manufacturer programs.

Responsibilities

• Complete prescription prior authorizations for all specialty and non-specialty medications prescribed by the care teams.
• Complete chemotherapy and infusion prior authorizations.
• Work closely with clinical staff to address insurance coverage restrictions.
• Work closely with insurance verification team to confirm up-to-date coverage details for all patients.
• Read and interpret patient charts, communicate required documentation to the team, write letters of medical necessity and document activities as required.
• Assist in submission of appeal requests, in accordance with prescriber requests.
• Respond to urgent authorization requests, ensuring prompt obtainment of appropriate approvals.
• Obtain financial assistance for patients, ensuring enrollment through drug delivery; navigate manufacturer programs and grants.
• Coordinate peer-to-peer reviews with insurance companies as requested.
• Engage regularly with clinic physicians, managing expectations and advancing organizational goals.

Skills

Excellent communication

Multi-tasking

Insurance billing

Pharmacy billing

ICD-10-CM

HCPCS

CPT codes

Problem solving

Education

High School Diploma or equivalent

Arkansas Pharmacy Technician License

Job description

Description

Join a team where compassion meets innovation.

Our oncology clinic is seeking a dedicated Drug Access Navigator to be the vital link that helps patients overcome financial and systemic barriers to life-changing cancer therapies. If you're driven by advocacy, problem-solving, and the opportunity to make a meaningful impact every day, this role puts you at the heart of improving patient care when it matters most.

Highlands Oncology began in 1996 with three physicians and a desire to change the face of oncology care in our community. Dr. Malcolm Hayward, Dr. Dan Bradford, and Dr. Thad Beck knew that patients do better at home, in the community where they live and work, and where their support system is already in place. In furthering that goal, Highlands has grown with the region from a single location 26 years ago, to 6 locations in Northwest and Northcentral Arkansas today employing more than 800 diverse team members.

As Northwest Arkansas continues to grow, so must the services and providers available in the region. Highlands Oncology is committed to remaining on the cutting edge to ensure our community has access to the very best cancer care. What we have is something quite unique right here in our own backyard with a caring multidisciplinary team focused on treating patients like family.

Job Summary:

The Drug Access Navigator (DAN) is responsible for managing prior authorizations, financial assistance, and medication access for chemotherapy, infusion therapies, specialty and non-prescription medications. This role ensures seamless patient care by working closely with physicians, clinical staff, insurance providers, and financial counselors to secure timely approvals and minimize patient financial burdens. The DAN must possess strong knowledge of insurance processes, oncology treatments, infusion therapies, and medication access while maintaining excellent communication and organizational skills. This individual must be able to organize, prioritize, manage, and communicate information effectively in both verbal and written forms. As part of the care team, the DAN will build effective relationships with other healthcare professionals and departments to ensure excellence in therapy and patient care.

Job Duties / Responsibilities:

• Complete prescription prior authorizations for all specialty medications and non-specialty medications prescribed by the care teams.
• Complete chemotherapy and infusion prior authorizations
  • Work closely with clinical staff to address any insurance coverage restrictions.
  • Work closely with the insurance verification team to confirm up-to-date coverage details for all patients.
• Read and interpret patient charts, communicate required documentation to the team, write letters of medical necessity and document activities as required.
• Assist in submission of appeal requests, in accordance with prescriber requests.
• Respond to urgent authorization requests, ensuring prompt obtainment of appropriate approvals.
• Obtain financial assistance for patients, ensuring completion of enrollment through drug delivery. Understand and regularly update access to various manufacturer programs, open funding through grants and foundations and available coupon cards.
• Coordinate peer-to-peer reviews with insurance companies as requested.
• Engage regularly with clinic physicians, managing expectations and working to advance organizational goals

Requirements

Required Skills/Abilities:

• Good communicator and able to interact well with a wide variety of people - excellent verbal and written communication skills.
• Able to multi-task and work efficiently in a fast-paced environment.
• Strong understanding of insurance - pharmacy billing and/or medical billing
• Strong understanding of ICD-10-CM, HCPCS, CPT codes and their relationship to treatment protocols
• Strong problem-solving skills and attention to detail

Certifications/Licenses/Education/or Experience in a related field:

• High School Diploma or equivalent required
• Prior experience in oncology medication access, infusion insurance claims, and prior authorizations preferred
• Prior experience in pharmacy insurance and prior authorizations preferred
• Arkansas Pharmacy Technician License may be required for certain job functions

Physical Requirements:

• May be seated for extended periods of time.
• Computer use that requires visual acuity, typing, use of mouse/keyboard, and staring at a screen for extended periods of time.
• Occasionally lifting objects of up to 25 pounds such as files, office supplies
• Walking and standing for continuous periods around the office or clinic as needed.
• Fine motor skills for tasks like typing, writing, handling small objects or equipment and materials.
• Primary setting is in an office with a desk and necessary computer equipment.

Work Environment:

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. Reasonable accommodation may be provided to enable individuals with disabilities to perform essential functions.
• Due to the nature of our business and the use of radiation and hazardous chemicals, it is imperative that all employees foster a culture and environment of safety.
• Safety Sensitive: In accordance with Arkansas code this position is designated as a safety sensitive position wherein the employee performing the job duties under the influence may constitute a threat to health or safety.