Drug Access Navigator

Overview:
Join a hospital where everyone makes a difference Cambridge Memorial Hospital (CMH) is a thriving community hospital that proudly provides acute care services including: Emergency, Surgery, Medicine, Women’s and Children’s Health, Intensive Care, Mental Health, and Inpatient Rehabilitation.

Our vision is to **_creating healthier communities together_**_._ Our dedicated and skilled staff are passionate about providing outstanding patient-centred care, and an exceptional patient experience to residents of the Waterloo Region and beyond.
- Healthcare of Ontario Pension Plan (HOOPP)
- Group benefits, including health and dental, for full-time employees
- Employee and Family Assistance Program
- Leadership and Quality Improvement Curriculum
- Career Development & Education Grant
- Wellness, & Wellbeing Program
- Diversity, Equity and Inclusion Initiatives

**Job Description**:
Reporting to the Director of Pharmacy, the Drug Access Navigator (DAN) works as part of the multi-disciplinary team at the Cambridge Memorial Hospital (CMH) outpatient Medical Day Clinic (MDC). The DAN role is to assist patients in navigating various drug coverage systems, helping to secure funding by 3rd party drug plans and minimize costs to patients. Working within the interdisciplinary team, the primary focus of the DAN is to evaluate, facilitate and coordinate access to medications for oncology patients. The DAN facilitates access to medications via Manufacturer-sponsored Compassionate Use Programs, Manufacturer-sponsored Patient Support Programs (PSPs), Ontario Drug Benefit (ODB), 3rd party insurance companies and out-of-pocket private payment options. The DAN may also be requested to offer support to other programs within CMH (ie. inpatient floors) to help obtain specially funded drugs or gain access to patient support programs.

**Key Responsibilities**
- Evaluates, facilitates, and coordinates access to medication assistance for oncology outpatients, and occasionally CMH inpatients by request
- Interviews patients/care support partner to complete a needs assessment for financial assistance for medications not covered by ODB or CCO’s new drug funding program
- Ensures patients are aware of all public and private support and funding options available such as Ontario’s Trillium Drug Program (a branch of ODB) and Manufacturer-sponsored PSPs
- Identifies options for drug coverage and assists patients and physicians with the completion of appropriate enrolment and access forms
- Tracks status of special funding requests, coordinates submission of additional information when required and communicates with patients and the rest of the interdisciplinary team when request decisions (approvals or denials) are received
- Determines all possible access for patients by maintaining up-to-date awareness of available reimbursement programs.
- Tracks all patient requests for support/funding and impending appeals
- Maintains record of discussions/correspondences with patients/care support partner and multi-disciplinary team
- Provides follow-up to physicians, patients/care support partner and involved members of the MDC team (charge nurses, pharmacists, clerks as applicable) to communicate outcomes (approvals, denials, appeals)
- Coordinates with Pharmacy Buyer regarding ordering and receiving of compassionate use drugs
- Participates in the non-funded approval process when no funding sources are available
- Coordinates, on the patient’s behalf, completion of forms/ paperwork required to obtain drug access
- Submits completed forms to programs, including all applicable supporting documentation (submission methods may include faxing or mailing, dependent on the program)
- Fields EAP requests for information, and monitors the status of EAP requests
- Acts as liaison and advocate for the patient with 3rd party payers
- Conducts ongoing follow-up of all form submissions and reimbursement paperwork for each program
- Maintains record of discussions/correspondence with outside stakeholders (e.g. status of request)
- Liaises with Drug Representatives to learn about new PSPs and stay current about existing PSPs (i.e. program changes and closures), and updates the team accordingly.
- Liaises with retail and specialty pharmacies (includes faxing prescriptions, arranging delivery)
- Liaises with outside infusion clinics to coordinate scheduling of treatments as applicable
- Documents ordering and receipt of shipments and tracks inventory of compassionate drugs
- Assists with other duties as required to support the oncology program

**Skills and Qualifications**

**Required**:
Graduate of a Healthcare-related Program through a recognized Community College.

Two to three years of related clinical (e.g. oncology) experience, including awareness of cancer terms and chemotherapy regimens.

A minimum of 2 years’ experience in a hospital setting.

Strong working knowledge of reimbursement terms for provincial and private payers. Including som