Social Worker- 258677

Medix™; United States; Remote; USD 48,000 - 59,000; Full time

Job summary

Medix is seeking an experienced Lead Patient Navigator Social Worker to guide a team of field-based Case Managers while driving patient access and reimbursement support. This player/coach role balances management with hands-on casework.

Applicants should hold an MSW and have 5–7+ years in pharma HUB/reimbursement, plus 3–5+ years of leadership. Remote work with national travel up to 25% is required; schedule includes EST hours and some overtime.

Qualifications

• MSW required; active state licensure not required.
• 5–7+ years in pharma HUB or reimbursement environments.
• 3–5+ years in leadership roles with performance management.
• Hands-on clinical social work experience within 10 years.

Responsibilities

• Directly manage a team of 3 field-based Case Managers and conduct regular 1-on-1s.
• Provide direct patient navigation for complex access cases and therapy compliance.
• Collaborate with HUB teams, providers, and pharmacies on verifications and authorizations.
• Cover shifts during spikes and support department operations from 9:00 AM–9:00 PM EST.
• Partner with sales and market access to align regional access goals.

Skills

Leadership

Team Management

Clinical Social Work

Patient Navigation

Reimbursement Knowledge

BVs & PAs

Travel Ready

Education

MSW

Job description

Job Title: Lead Patient Navigator Social Worker

Location: 100% Remote - Must be comfortable with National travel

Schedule: Monday – Friday, department operating hours between 9:00 AM – 9:00 PM EST (Requires schedule flexibility and occasional overtime)

Travel: Up to 25% national travel (approx. 8 times per year for patient/field visits and team conferences)

$35-$43 hourly (depending on experience)

Position Overview

We are seeking an experienced Lead Patient Navigator Social Worker to guide and mentor a team of field-based Case Managers while actively driving patient access and reimbursement support. In this true "player/coach" role, you will balance team management, operational leadership, and direct patient outreach—stepping in hands‑on to handle complex cases, cover shifts, and support caseloads as needed.

If you are a compassionate clinical social worker with extensive pharma HUB/reimbursement experience and a proven leadership background, we invite you to apply.

Key Responsibilities

• Team Leadership & Management: Directly manage a team of 3 field‑based Case Managers. Conduct regular 1-on-1 meetings, set performance goals (MBOs), deliver evaluations, and handle performance management or disciplinary actions.
• Direct Patient Navigation: Maintain a direct caseload (~10% of standard case volume), delivering personalized support for complex access cases, insurance navigation, and ongoing therapy compliance.
• Access & Reimbursement Support: Collaborate directly with patients, healthcare providers, specialty pharmacies, and HUB teams to navigate Benefits Verifications (BVs), Prior Authorizations (PAs), and complex insurance/Medicare challenges.
• Operational Agility & Support: Act as a hands‑on lead by covering shifts, stepping in during volume spikes, and filling in during team absences across the department's operating window (9:00 AM – 9:00 PM EST).
• Cross‑Functional Collaboration: Partner with field sales reps and market access teams to educate field personnel and align regional access performance with overarching program objectives.

Required Qualifications

• Education: Master of Social Work (MSW) required. (Active state licensure is not required.)
• Reimbursement & HUB Experience: 5–7+ years working within a pharma HUB or reimbursement environment (10+ years strongly preferred).
• Leadership Experience: 3–5+ years in a team lead, supervisory, or management role with demonstrated experience conducting 1-on-1s, performance evaluations, and managing employee relations/disciplinary actions.
• Clinical Background: Direct, hands‑on clinical social work experience within the last 10 years (e.g., hospital, skilled nursing facility, direct patient counseling).
• Domain Knowledge: Strong, working expertise in Benefits Verifications (BVs), Prior Authorizations (PAs), Medicare/Medicaid processes, and specialty pharmacy workflows.
• Flexibility & Travel: Ability to work a flexible schedule within the 9:00 AM – 9:00 PM EST window and willingness to travel nationally up to 25% (must reside within 45 minutes of a major airport).

Preferred Qualifications

• Proven experience launching a new pharma HUB or patient access program from the ground up.
• Specific clinical or operational background in neurology.