Patient Care Navigator

Job ID JR0131670

Category Managed Care, Medical & Medical Research

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.

**Job Summary**:
The Patient Care Navigator is responsible for managing all aspects of the Navigation Support Program for approved physicians within the clinic model. The Patient Care Navigator works independently in a virtual capacity. The individual works directly with the Physicians and associated health care providers to provide a single point of contact for Patients, Physicians and the various patient support programs for each Biologic provided within the clinics.

The Patient Care Navigator is responsible for directing the referral information to the applicable patient support program on behalf of the Physician and obtaining any patient information that the specific patient support program requires to complete reimbursement on behalf of the patient.

The Patient Care Navigator also works directly with internal and external patient support programs to help secure funding and to provide clinical expertise in understanding special authorization criteria and provide appropriate recommendations to secure financial assistance with various insurers commercially and privately.

The main objective of this service is to provide patients access to an agnostic clinic with navigation support to seamlessly support Physicians and patients in their medical journey and to provide easy access to all the patient support programs to get patients on drug therapy without delays.

**Section A - Specific Responsibilities**:

- To work collaboratively with all patient support coordinators from the various biologic patient support programs to assist in collecting the necessary paperwork from patient files/charts (i.e. Chest x-ray results, TB test results, lab test results, medication lists, past and current therapies and response etc.) needed to complete patients reimbursement investigation.
- To provide medical support to patients, health care providers, including education on specific diseases and therapies.
- Work directly with the McKesson reimbursement specialists and the Physician to secure funding for their patients’ therapies.
- Assisting Physicians with provincially mandated biologic switches from originator molecules to Biosimilars
- Assisting the Physicians in completing special authorization forms, enrollment forms for various biologic patient support programs, and any other documentation required.
- To provide Physician therapy guidelines and insurance criteria to manage Physician expectations in respect to reimbursement.
- Ensures patient services are coordinated and tracked utilizing the online PSP program according to KPI’s to result in expediated access to therapy.
- Coordinates patient therapy appointments with the Patient Care Coordinators and acts as a liaison with the various Pharmacy teams to coordinate medication delivery with therapy dates, and to ensure all needed documentation is delivered both parties.
- To report Adverse Events following program Standard Operating Procedures
- To be able to evaluate current program elements to meet the needs of assigned Physicians and make recommendations for modifications. Adjustments made based on clinic and remote Physician needs to be approved by Director of Providers Solutions.
- Administer and adhere to case-management protocols, including clinical monitoring, data collection, on-going patient follow up, compliance and adherence, drug therapy disruption/discontinuation monitoring, adverse event reporting with various drug programs, and liaison with primary healthcare providers.
- Cross train and collaborate with their navigator colleagues in other therapeutic areas (oncology/neurology)

IBD patient care Responsibilities:

- Responsible to be a center point person for the multi-disciplinary team coordination of patient care in immunology. Oncology background will also be considered.
- Available to patients to provide ongoing telephone support, consultation and assessment of drug therapies assessing for adherence, dose optimization, drug response and any events such as surgeries, infections, hospitalizations etc. that would affect scheduled infusions, and/or injections and reporting back to the Physician.
- Develops strong working relationships with Physician’s and Physician office staff, providing additional office support to ensure smooth maintenance of patient enrolled in the program as n