Social Worker- 258677
Job Title: Lead Patient Navigator Social Worker 📍Location: 100% Remote - Must be comfortable with National travel 🗓️Schedule: Monday – Friday, department operating hours between 9:00 AM – 9:00 PM EST (Requires schedule flexibility and occasional overtime) ✈️Travel: Up to 25% national travel (approx. 8 times per year for patient/field visits and team conferences) 💸 $35-$43 hourly (depending on experience) Position Overview We are seeking an experienced Lead Patient Navigator Social Worker to guide and mentor a team of field-based Case Managers while actively driving patient access and reimbursement support. In this true "player/coach" role, you will balance team management, operational leadership, and direct patient outreach—stepping in hands-on to handle complex cases, cover shifts, and support caseloads as needed. If you are a compassionate clinical social worker with extensive pharma HUB/reimbursement experience and a proven leadership background, we invite you to apply.
Key Responsibilities
Team Leadership & Management: Directly manage a team of 3 field-based Case Managers. Conduct regular 1-on-1 meetings, set performance goals (MBOs), deliver evaluations, and handle performance management or disciplinary actions. Direct Patient Navigation: Maintain a direct caseload (~10% of standard case volume), delivering personalized support for complex access cases, insurance navigation, and ongoing therapy compliance. Access & Reimbursement Support: Collaborate directly with patients, healthcare providers, specialty pharmacies, and HUB teams to navigate Benefits Verifications (BVs), Prior Authorizations (PAs), and complex insurance/Medicare challenges. Operational Agility & Support: Act as a hands-on lead by covering shifts, stepping in during volume spikes, and filling in during team absences across the department's operating window (9:00 AM – 9:00 PM EST). Cross-Functional Collaboration: Partner with field sales reps and market access teams to educate field personnel and align regional access performance with overarching program objectives.
Required Qualifications
Education: Master of Social Work (MSW) required. (Active state licensure is not required.) Reimbursement & HUB Experience: 5–7+ years working within a pharma HUB or reimbursement environment (10+ years strongly preferred) . Leadership Experience: 3–5+ years in a team lead, supervisory, or management role with demonstrated experience conducting 1-on-1s, performance evaluations, and managing employee relations/disciplinary actions. Clinical Background: Direct, hands-on clinical social work experience within the last 10 years (e.g., hospital, skilled nursing facility, direct patient counseling). Domain Knowledge: Strong, working expertise in Benefits Verifications (BVs), Prior Authorizations (PAs), Medicare/Medicaid processes, and specialty pharmacy workflows. Flexibility & Travel: Ability to work a flexible schedule within the 9:00 AM – 9:00 PM EST window and willingness to travel nationally up to 25% (must reside within 45 minutes of a major airport).
Preferred Qualifications
Proven experience launching a new pharma HUB or patient access program from the ground up. Specific clinical or operational background in neurology.