Job Summary

The Patient Care Navigator (PCN) serves as the primary point of contact for patients, physicians, and patient support programs (PSPs). Working independently in a virtual environment, the PCN coordinates reimbursement, access to therapy, patient education, and ongoing care navigation to support timely and seamless patient access to treatment.

The PCN collaborates with physicians, healthcare providers, reimbursement specialists, pharmacies, and PSPs to facilitate patient enrollment, reimbursement support, funding assistance, and treatment coordination. The role requires strong clinical knowledge, relationship management skills, and the ability to navigate complex healthcare and reimbursement systems.

The primary objective of this service is to provide patients with access to an agnostic clinic model that delivers comprehensive navigation support, enabling physicians and patients to access therapy efficiently and without unnecessary delays.

Section A – Specific Responsibilities

- Collaborate with patient support program coordinators and provide required documentation from patient charts and records, including diagnostic tests, laboratory results, medication histories, prior therapies, and clinical assessments required for reimbursement and treatment access.

- Provide clinical and disease-state education to patients, caregivers, physicians, and other healthcare professionals.

- Work directly with McKesson reimbursement specialists and physicians to support funding and reimbursement approval for prescribed therapies.

- Assist physicians with provincially mandated transitions from originator biologics to biosimilars.

- Support completion of special authorization forms, enrollment forms, reimbursement documentation, and other program-specific requirements.

- Provide physicians with therapy guidelines, reimbursement criteria, and payer requirements to support informed treatment decisions and manage reimbursement expectations.

- Ensure patient services are coordinated, documented, and tracked within applicable platforms in accordance with established KPIs to support expedited access to therapy.

- Coordinate patient treatment appointments and collaborate with internal teams and pharmacies to ensure medication delivery aligns with treatment schedules.

- Report adverse events in accordance with program Standard Operating Procedures, regulatory requirements, and company policies.

- Evaluate existing processes and recommend improvements to better support physician, patient, and program needs.

- Administer and adhere to case management protocols, including patient monitoring, follow-up, documentation, adherence support, therapy disruption monitoring, adverse event reporting, and communication with healthcare providers.

- Cross-train and collaborate with Navigators across therapeutic areas, including Immunology and Oncology, to support operational excellence and knowledge sharing.

- Maintain compliance with applicable privacy legislation, corporate policies, regulatory requirements, and Standard Operating Procedures.

IBD Patient Care Responsibilities

- Serve as a central point of contact for multidisciplinary coordination of patient care within Immunology.

- Provide ongoing patient support, education, consultation, and therapy assessments, including adherence monitoring, treatment response, dose optimization, and identification of clinical events that may impact therapy.

- Develop strong working relationships with physicians, clinic staff, and healthcare partners to support continuity of care.

- Coordinate pre-biologic screening requirements, including laboratory testing, tuberculosis screening, imaging, and immunization assessments.

- Coordinate routine bloodwork, therapeutic drug monitoring, and fecal calprotectin testing, as ordered by the prescribing physician.

- Provide patients with education, tools, and resources throughout their treatment journey.

- Coordinate therapy changes, dose adjustments, and treatment transitions with patient support programs and healthcare providers.

- Coordinate infusion appointments and required follow-up activities with patients and clinics.

- Participate in therapy-specific training programs and educational sessions as required.

- Attend meetings, conferences, and educational programs to maintain clinical knowledge and support patient and provider education.

- Identify risks and participate in continuous quality improvement initiatives to enhance patient outcomes and service delivery.

- Ensure accurate, complete, and timely documentation within the Maple database and other applicable systems.

- Demonstrate behaviors aligned with McKesson's iCare and LeadRx principles.

- Maintain active professional licensure in good standing within the applicable province.

- Maintain knowledge of and adherence to corporate, regulatory, and business unit policies and procedures.

Section B – Key Requirements (Knowledge, Skills, Abilities and Experience)

- Bachelor's Degree in Nursing, Pharmacy, or a related healthcare discipline.

- Experience in Gastroenterology and/or Immunology.

- Demonstrated ability to build collaborative relationships with patients, physicians, healthcare providers, patient support programs, pharmacies, and internal stakeholders.

- Self-directed and motivated, with the ability to work independently while contributing effectively as part of a team.

- Strong problem-solving, organizational, and decision-making skills with the ability to manage multiple priorities.

- Business acumen and the ability to thrive in a corporate healthcare environment.

- Excellent clinical assessment and clinical decision-making skills.

- Experience with biologic therapies and administration.

- Experience with reimbursement navigation, special authorization processes, funding appeals, and patient access support.

-Knowledge of public and private reimbursement systems, funding pathways, and payer requirements.

- Strong analytical skills, including the interpretation of policies, regulations, and reimbursement criteria.

- Experience in pharmaceutical, healthcare, sales, marketing, or business administration environments is considered an asset.

- Intermediate proficiency with Microsoft 365 applications, including Word, Excel, PowerPoint, Teams, Outlook, and Copilot.

- Experience using patient support program platforms, electronic medical records, and patient management systems.

- Ability to travel as required, including occasional overnight travel.

- Ability to work effectively in a dynamic and rapidly changing healthcare environment.

- Excellent verbal and written communication skills.

- Strong interpersonal, stakeholder management, and relationship-building skills.

Section C – What You'll Gain in This Role

- Exposure to advanced therapies and specialty healthcare.

- Development of expertise in reimbursement, patient access, and navigation services.

- Experience collaborating with multidisciplinary healthcare teams and industry partners.

- Opportunity to support complex patient journeys and improve access to therapy.

- Growth in leadership, stakeholder management, problem-solving, and clinical decision-making skills.

- Ongoing professional development through training, conferences, and industry engagement.

- Experience working in an innovative, patient-centered healthcare environment focused on improving outcomes and access to care.