Care Navigator, Nurse

Purpose:

The Care Navigator (CN) is a telehealth registered nurse who provides compassionate, clinically informed support to patients with rare or complex diseases. The CN combines expertise in clinical and product knowledge, empathetic patient training with clarity, regulatory and compliance awareness, and meticulously detailed documentation. This role ensures timely therapy initiation by educating patients on insurance processes, resolving access barriers, and guiding them through benefits and affordability options. Focused on continuity of care, the CN serves as the primary point of contact, offering individualized adherence coaching and maintaining elevated levels of engagement throughout the treatment journey. Acting as a vital link between patients, healthcare provider offices, infusion sites of care, and both internal /external teams, the CN promotes efficient patient journey coordination and optimal health outcomes.

Key Responsibilities

Clinical Education & Adherence Support

• Apply motivational interviewing techniques and patient assessment tools to evaluate patients’ current knowledge, ability, and readiness to learn.
• Utilize approved training materials and resources to educate patients on disease state and infusion center of care logistics.
• Offer guidance on therapy initiation, medication administration, dosing schedules, side effect management strategies, and logistics.
• Design personalized adherence programs with scheduled follow-up touchpoints to build trust, reinforce education, monitor therapy continuation, and empower patient self-management. 
• Assist patients with affordability options, including copay assistance and other financial support programs.

Program Operations, Compliance & Quality

• Ensure all program activities comply with established contract deliverables including business rules, KPI’s, and regulatory requirements.
• Manage patients onboarding and support patients through the patient journey including coordination with HCP offices and sites of care as needed.
• Build strong professional relationships with patients, caregivers, health care provider offices, pharmacies, and manufacturer field representatives.
• Identify and escalate risks, safety issues, adverse events, and product complaints per policy.
• Engage in team discussions, take initiative to improve program efficiency, patient experience, and clinical workflow improvements.
• Maintain confidentiality and full compliance with HIPAA and patient privacy laws.
• Demonstrate positivity, accountability, and commitment to nursing standards and practice.

Required Qualifications

• Active, unrestricted RN license in good standing; Associate or Bachelor’s degree in Nursing required.
• Minimum 2–3 years of clinical nursing experience; telehealth call center with adherence support, patient service case management, or pharmaceutical/biotech experience highly desirable.
• Strong verbal and written communication skills; ability to clearly explain complex concepts virtually.
• Ability to manage caseloads independently, prioritize tasks, and meet all program deliverables.
• Previous experience engaging with multiple stakeholders (health care offices; infusion centers of care, specialty pharmacies, etc.)
• Proven ability to resolve complex issues with urgency, empathy, professionalism, and a positive outlook.
• Proficiency in Microsoft Word, Excel, and Outlook; strong computer and data-entry skills.
• Demonstrated ability to exercise independent judgment and maintain detailed documentation.

Preferred Qualifications

• Clinical experience in infusion and/or rheumatology a plus.
• Experience with adherence outreach - familiarity utilizing motivational interviewing, or behavioral coaching.
• Knowledge of third-party reimbursement and affordability coverage.
• Ability to adapt to a fast-paced, evolving healthcare environment and navigate multiple systems.
• Familiarity with adverse events and product complaint identification and reporting.

Work Environment

RareMed offers a hybrid work structure, combining remote work and in-office requirements. The frequency of onsite requirements will vary depending on role, operational needs, meetings, client visits, or team collaboration activities. Employees must be within commuting distance to Pittsburgh, PA, and able to report to the office when needed. We will provide advance notice when possible. This role routinely involves standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. When telecommuting, employees must have reliable internet access to utilize required systems and software required for the position's responsibilities. The amount of time the employee is expected to work per day or pay period will not change while working from home. Employees are responsible for the set-up of their home office environment, including physical set-up, internet connection, phone line, electricity, lighting, comfortable temperature, furniture, etc. Employee’s teleworking space should be separate and distinct from their “home space” and allow for privacy. 

Physical Demands
 While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms. 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function of the job.