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Financial Navigator

Details

TailorMed, a fast-growing startup, was founded with a personal mission to help patients and healthcare Providers tackle the financial challenges of care delivery. TailorMed’s platform automatically identifies alternative funding opportunities that help patients afford their care, and therefore, increase hospitals’ financial performance. 

As Financial Navigator you will engage with patients proactively, identify and evaluate how to maximize the patient’s health insurance benefits and reduce economic barriers to care by utilizing knowledge of available patient assistance programs, financial advocacy tools, and resources. You will accurately explain insurance coverage and assistance options and skillfully communicate with patients and their caregivers focusing on issues of cost of care, patient assistance support, and additional resources.

A TailorMed Financial Navigator will need to be a flexible team player with a passion for helping patients and strive to always improve financial performance for patients and Providers alike. 

Responsibilities

  • Manage, track, and report on all financial advocacy and patient access services interactions
  • Ensure ongoing awareness of policy requirements from payers for coverage of services
  • Maintain contact with patients along the continuum of care
  • Identify and explain the patient’s out-of-pocket costs
  • Identify other costs, such as expenses related to transportation, childcare, and lodging
  • Identify patient assistance programs and resources that can help with non-treatment-related costs
  • Assist patients and family/caregivers in applying to assistance program(s)
  • Track application status until a determination is made
  • Maintain up-to-date knowledge of requirements for enrolling patients in: manufacturer, state, and local medication assistance programs; disease-specific assistance grants from non-profit organizations; Medicare prescription benefits; Social Security Low-Income Subsidy (LIS); and any state and federal assistance subsidy
  • Evaluate patients for available assistance including, but not limited to, federal and state subsidies or programs, disease-specific assistance programs, patient assistance programs, and local community resources
  • Liaison with clients using TM Service to provide best in class service solutions that maximize their financial opportunities
  • Be a point of escalation and center of expertise for internal queries relating to financial advocacy 
  • Maintain the vision/mission of TailorMed

Requirements

  • High level of initiative and ability to self-direct to solve financial problems of patients
  • Excellent organization, time management, conflict resolution and negotiation skills 
  • Ability to effectively communicate with patients newly diagnosed, who may be very emotional, angry, overwhelmed, etc.
  • Ability to utilize software and telecommunications equipment needed to do the job
  • Ability to work in a high volume caseload environment and deal effectively with rapidly changing priorities
  • Minimum of a bachelor’s degree or equivalent experience in business, life sciences, finance, or related area
  • Knowledge of health insurance rules/regulations
  • 2-5 years of experience in a financial advocacy role (advantage)
  • Knowledge of healthcare industry revenue cycle (Facility/Hospital System, Professional/Physician Office, Pharmacy/Specialty)
  • Deep familiarity with Assistance Programs and government insurance plans
  • Experience delivering client-focused solutions to customer needs

The Financial Navigator position is a full-time salaried position

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