Lead Patient Access & Reimbursement Navigator

CareMetx, LLC; United States; Remote; USD 110,000 - 160,000; Full time

Job summary

CareMetx is hiring a Lead Patient Navigator Social Worker to manage and coach a field-based team that educates patients and families on product access and reimbursement. You will drive strategies to improve therapy access and ensure compliance, working with providers and payers to resolve coverage questions.

Applicants should have 10+ years in pharma/healthcare, a MSW, and at least 3 years of people management, with flexible hours for coverage and remote work options.

Qualifications

• 10+ years of experience in pharma/healthcare.
• 3+ years reimbursement management experience.
• 3+ years direct people management experience.
• Master of Social Work (MSW) required.
• Schedule flexibility to provide backup coverage outside standard hours (9 am–5 pm).

Responsibilities

• Lead a field-based team of Case Managers delivering patient access and reimbursement support.
• Educate teams on patient access issues and reimbursement processes.
• Coordinate with pharmacists, hub, and providers for therapy access.
• Manage case histories in CRM and monitor performance against objectives.
• Provide backup coverage during absences and coordinate travel as needed.

Skills

Leadership

Communication

Interpersonal skills

Analytical skills

Education

MSW

Tools

Word

Excel

PowerPoint

Job description

CareMetx is hiring a Lead Patient Navigator Social Worker to manage and coach a field-based team that educates patients and families on product access and reimbursement. You will drive strategies to improve therapy access and ensure compliance, working with providers and payers to resolve coverage questions.

Applicants should have 10+ years in pharma/healthcare, a MSW, and at least 3 years of people management, with flexible hours for coverage and remote work options.