Financial Navigator - Pittsburgh, PA bei House Rx

We're looking for an On-Site Financial Navigator in Pittsburgh, PA to help us make specialty medications more accessible and affordable for patients. Keep reading to learn more about the role, our team and why House Rx is the right next step in your career. 

About the Role

As a pivotal member of the House Rx team, you will work closely with specialty care clinics and the House Rx team to improve the specialty pharmacy experience for specialty patients and their caregivers.  This is an onsite role at an office location in Pittsburgh, PA. 

What You’ll Do

The Financial Navigator, Specialty Pharmacy is a critical member of the patient care team, responsible for ensuring that patients have access to the financial resources necessary to afford their specialty medications. This role acts as a liaison between patients, prescribers, pharmaceutical manufacturers, and insurance companies to identify and resolve financial barriers to treatment and coordinate financial support. The Financial Navigator will be an expert in the complex landscape of specialty pharmacy funding, including insurance benefits, patient assistance programs, grants, and co-pay foundations.

Key Responsibilities:

Patient Financial Advocacy:

• Partner with patients and caregivers to understand financial needs and reduce barriers to treatment
• Conduct comprehensive financial needs assessments for new and existing specialty pharmacy patients.
• Assess insurance benefits, out-of-pocket costs, and eligibility for patient assistance programs, copay foundations, and grants
• Educate patients on their insurance benefits, including co-pays, deductibles, and out-of-pocket maximums.
• Assist patients in enrolling in appropriate financial assistance programs (e.g., manufacturer co-pay cards, foundation grants, patient assistance programs) and maintain timely follow-up to ensure continuity of care

• Insurance and Prior Authorization:
• Work closely with the prior authorization team to understand insurance denials and develop strategies for appeal.
• Verify patient insurance coverage and benefits for specialty drugs, identifying potential gaps in coverage.
• Collaborate with prescribers and their staff to gather necessary documentation for prior authorizations and appeals.
• Program Management and Coordination:
• Maintain an up-to-date knowledge base of all available manufacturer and non-profit patient assistance programs.
• Manage patient enrollment and re-enrollment in assistance programs, ensuring all paperwork and deadlines are met.
• Track and report on the status of patient assistance applications and financial support.
• Operational and Administrative:
• Document all patient interactions and financial information accurately in the pharmacy management system and/or electronic health record.
• Collaborate closely with House Rx operational and clinic teams to ensure patients start and stay on therapy with minimal disruption
• Generate reports on financial assistance outcomes, patient savings, and program utilization.
• Adhere to all HIPAA regulations and maintain patient confidentiality.
• Collaborate with the pharmacy team, billing department, and clinical staff to ensure a seamless patient experience.

About You

• You are comfortable engaging with patients, providers, and all members of the care team both in-person and over the phone
• You have experience navigating specialty medication benefits investigation, prior authorization, and financial assistance
• You are excited about working in a start-up environment and helping to build workflows and processes from the ground up
• You enjoy learning new technologies and are proficient in some common pharmacy software systems (QS1, ComputerRx, PioneerRx, WAM, etc). Bonus points if you have worked in EMR systems (EPIC, Cerner, NextGen, etc) or specialty pharmacy systems (Therigy, Asembia1, ScriptMed, etc)
• You are familiar with specialty medications, including medications used in autoimmune, endocrinology, and oncology. Willingness to learn therapeutic areas you are not familiar with is great
• You are highly organized, detail-oriented, and a proactive problem solver interested in positively impacting each patient’s pharmacy experience
• You are an initiative taking individual contributor who can also promote teamwork and collaboration amongst colleagues 
• You have experience in healthcare, pharmacy, patient access, or financial assistance navigation (specialty pharmacy experience strongly preferred)
• You have a strong understanding of health insurance, copay assistance, grants, and patient support programs
• You demonstrate empathy and communicate with excellence when working with patients and caregivers

Qualifications:

• Education: Bachelor's degree preferred, preferably in a healthcare, finance, or business-related field. An equivalent combination of education and experience may be considered.
• Experience:
• Minimum of 2-3 years of experience in a healthcare setting, with a strong preference for experience in a specialty pharmacy, hospital, or clinic.
• Proven experience in patient financial advocacy, medical billing, or insurance authorization.
• Demonstrated knowledge of the complex landscape of specialty drug funding, including manufacturer co-pay programs and non-profit foundations.

Excited about the opportunity, but worried you don’t meet all the requirements? Apply anyway, and give us both the chance to find out.

Expected Hourly Rate:  $25/hr - $32/hr

This range represents the low and high end of the anticipated base salary/wage. The actual base salary/wage will depend on several factors, including experience, knowledge, and skills. Actual compensation packages may include other elements equity, paid time off and benefits.

Why You Should Join Our Team

A career at House Rx offers the chance to work with a talented group of entrepreneurs, healthcare professionals, and technology builders who are passionate about improving specialty care and making it easier for patients to access the medication that they need.

At House Rx, we strive to build and maintain an environment where employees from all backgrounds are valued, respected and have the opportunity to succeed. You'll find a culture that supports open communication, embracing failure as a learning opportunity, and always being open to new ideas—no matter how radical. We are a remote-first company, however some pharmacy operations roles require onsite clinic presence. We’re committed to creating a positive and collaborative culture to achieve our mission, all while supporting our team members in all aspects of their lives—at home, at work and everywhere in between. 

In particular, we offer:

• Paid time off
• Generous parental leave 
• Comprehensive healthcare, vision and dental benefits
• Competitive salary and equity stake

We’re backed by forward-thinking investors committed to transforming healthcare, including Bessemer Venture Partners, First Round Capital, LRV Health, Khosla Ventures, Maverick Ventures, 1984.vc, and Character.