Oncology Patient 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

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