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Role Description

The Nurse Navigator will be responsible for utilizing their professional nursing skills, clinical experience, ability to foster relationships, strong empathy, and to provide personalized high-touch virtual support to patients and healthcare professionals (HCPs) with an emphasis on reimbursement, patient access, and therapy coordination. The role will engage with patients and HCPs to ensure patients have seamless access to treatment. The HCM Navigator will guide HCPs through any access barriers for their patients while also heavily collaborating cross-functionally with the REMS vendor, HUB, specialty pharmacy, and field teams to optimize the patient treatment journey. You will leverage their clinical knowledge while combining technical expertise to deliver best-in-class support, customer service, and ongoing guidance to these patients and providers.

Essential Functions

• Provide virtual high-volume omnichannel support through email, chat, text, virtual connections, and inbound or outbound calls to patients, HCPs, REMS vendor, HUB, specialty pharmacy, and field teams.
• Demonstrate strong empathy and high emotional intelligence to engage patients/HCPs effectively, creating individual relationships built on trust and rapport.
• Provide proactive support to HCP office issues related to REMS, reimbursement, insurance coverage, and product dispense.
• Act as a primary point of contact for patients to provide comprehensive disease/therapy education and access to therapy (including benefit verification, prior authorizations, and navigating insurance reimbursement processes).
• Prepare structured case status reports for ongoing HCP email or telephonic review.
• Collaborate and work cohesively with Momentum Inbound team to identify gaps, barriers, and opportunities to improve process and overall patient/HCP experience.
• Communicate complex information effectively and empathetically to patients/HCPs.
• Accurately complete patient engagements based on provided criteria.
• Ensure the success of the program through collaborative partnerships with patients, HCPs, field, and operational partners.
• Lead and facilitate weekly touchpoint meetings with field partners to review wins, priorities, and action items; document outcomes and drive timely follow-through.
• Monitor and prioritize daily and weekly workload to anticipate needs, rebalance tasks, and ensure timely follow-through on commitments.
• Work and communicate cohesively within a team to identify collaborative opportunities, enable process improvement, and escalate as needed.
• Provide manager and the account team voice of the customer feedback on the product, support, and insights to enable enhancements.
• Ensure all activities are conducted in a manner that complies with all Momentum, client, and industry-mandated rules and regulations.
• Complete AEPQC reporting and provide all communications in a compliant manner.

Required Education and/or Experience

• Bachelors degree preferred.
• Experience in a telephonic support role centered in patient access, reimbursement, or care coordination/case management roles.
• Experience with high volume inbound/outbound call center.

Required License and/or credential(s)

• Current, unrestricted nursing license (RN, NP).

Required Skills

• High emotional intelligence and ability to exhibit empathy to meet each patient where they are.
• Demonstrated flexibility and adaptability in a fast-paced environment with shifting priorities, new information, and changing business demands.
• Strong clinical skills and experience with medication compliance, specialty pharmacy knowledge, understanding of the insurance approval process, and motivational interviewing.
• Maintain strong time management and organizational discipline while coordinating concurrent workstreams and navigating frequent interruptions.
• Desire and ability to create an individualized relationship with patients as they progress through their journey.
• Ability to accurately recognize and report AEPQC information.
• Optimistic, upbeat, and enthusiastic in times of challenge and constant change.
• Ability to deliver outstanding patient experience.
• Demonstrate experienced competency and ability to independently navigate technology using multiple platforms, computer screens, and other technical components (Ex: Telephony Systems, CRM tools, Microsoft Suite).
• Advanced knowledge of written and verbal communication skills and problem-solving techniques.
• Detail-oriented, highly organized, and able to work through ambiguity.
• Able to work independently, self-motivated, managing workload with minimal supervision.
• Ability to maintain cases and complete calls on time.
• Ability to maintain compliant conversations and documentation in a high-volume role.
• Ability to maintain patient confidentiality by using the headset during all conversations, maintaining a private environment for home office without distraction.
• Ability to maintain great flexibility in an ever-changing environment and willingness to learn other therapies or float to other brands as needed.
• Willingness to assist in shift coverage as needed outside of typical hired shift.

Special Position Requirements

• Travel: As required; less than 10%.

Working Conditions

• Work is generally sedentary in nature but may require standing and walking for up to 10% of the time.
• The working environment is generally favorable. Lighting and temperature are adequate, and there are no hazardous or unpleasant conditions caused by noise, dust, etc.
• Work is generally performed within an office environment, with standard office equipment available.

Physical Requirements

• Must be able to read, write, and communicate fluently in English.
• Ability to communicate effectively (hear, listen, speak) with or without reasonable accommodations.