Demo

Patient Navigator

Vital Care Infusion Services
Franklin, TN Full Time
POSTED ON 3/10/2025
AVAILABLE BEFORE 6/10/2025

Vital Care (www.vitalcare.com) is the premier pharmacy franchise business with franchises serving a wide range of patients, including those with chronic and acute conditions. Since 1986, our passion has been improving the lives of patients and healthcare professionals through locally-owned franchise locations across the United States. We have over 100 franchised Infusion pharmacies and clinics in 35 states, focusing on the underserved and secondary markets. We know infusion services, and we guide owners along the path of launch, growth, and successful business operations.

What we offer :

  • Comprehensive medical, dental, and vision plans, plus flexible spending, and health savings accounts.
  • Paid time off, personal days, and company-paid holidays.
  • Paid Paternal Leave.
  • Volunteerism Days off.
  • Income protection programs include company-sponsored basic life insurance and long-term disability insurance, as well as employee-paid voluntary life, accident, critical illness, and short-term disability insurance.
  • 401(k) matching and tuition reimbursement.
  • Employee assistance programs include mental health, financial and legal.
  • Rewards programs offered by our medical carrier.
  • Professional development and growth opportunities.
  • Employee Referral Program.

Job Summary :

The Patient Navigator position is responsible for supporting patient access to therapies associated with a Vital Care enhanced services program designed in coordination with a trade partner. Excellent interpersonal communication, organization, and problem-solving skills are critical to success for this position.

Duties / Responsibilities :

  • Carries out projects delegated by the Program Manager in the specified time frame.
  • Uses all available resources to solve problems related to trade needs / requests or to triage requests to the appropriate team member.
  • Uses a system to organize and ensure follow-up on all requests related to trade programs.
  • Identifies opportunities to improve business operations and resources related to trade relations.
  • Completes tasks related to trade contracting.
  • Completes other duties deemed necessary by the Program Manager to accomplish the goals and mission of the department and company.
  • Designed provider Ambassador, communicating to prescribers and single point of contact for HUB.
  • Working with the Program Manager on enhanced services for manufacturers contracts.
  • Verify patient eligibility by conducting benefit verification.
  • Assists in the data entry and completion of authorization forms and notification. Obtains insurance prior authorization for patients and reauthorization for additional treatments.
  • Ensures insurance carrier documentation requirements are met.
  • Reviewing Prior authorization denials and complete appeals
  • Contacting insurance companies to discuss insurance payments and denials.
  • Required Skills / Abilities :

  • Proven and documented track record of increased performance and achievements.
  • Ability and desire to use technology and learn new software applications as required.
  • Excellent problem solving and organizational skills.
  • Self-motivated and able to work independently in a fast-paced environment.
  • Teamwork experience and characteristics of a team player.
  • Education and Experience :

  • High school diploma / GED or equivalent experience.
  • Certified pharmacy technician experience preferred.
  • At least 3-5 years of experience in benefits verification, prior authorization, and insurance denials
  • At least 3-5 years' experience in health care, including understanding of health plan related operations.
  • Proficiency in Microsoft Office suite software products.
  • Be part of an organization that invests in you! We are reviewing applications for this role and will contact qualified candidates for interviews.

    Vital Care Infusion Services is an equal-opportunity employer and values diversity at our company. We do not discriminate on the basis of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status, or any other basis protected by applicable federal, state, or local law.

    Vital Care Infusion Services participates in E-Verify.

    This is a full-time position.

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