Oncology Financial Navigator

About the role

Vail Health is the world’s most advanced mountain healthcare system, featuring a 520,000-square-foot, 56-bed hospital with exceptional care and scenic views in Vail. The Oncology Financial Navigator improves and maximizes revenue capture at Shaw Cancer Center (SCC) and Vail Health Hospital (VHH) by educating and enrolling oncology patients into Third Party Assistance (TPA) programs. These programs reduce patients’ out-of-pocket expenses, maximize savings for VHH’s charity program, and minimize patients falling into collections. The Navigator assists all SCC patients in accessing financial resources to pay for prescribed therapy and avoid financial toxicity due to care costs.

The role involves researching and enrolling eligible patients into financial assistance programs from internal and external resources, including the VHH Financial Assistance Program, copay assistance programs, drug replacement programs, grants from national oncology foundations, and local/community resources.

Responsibilities

• Meet with new patients and caregivers to provide education on insurance benefits and estimated out-of-pocket expenses for prescribed therapy prior to treatment initiation.
• Help patients complete applications for financial assistance, pharmaceutical assistance, and government programs in a timely and HIPAA-compliant manner.
• Work closely with the Oncology Social Worker on crossover patients and make referrals as necessary.
• Track all TPA funding received and report to the VP of Oncology bi-monthly; report trending and forecasting for special projects as requested.
• Maintain an extensive database of TPA programs for oncology patient financial assistance and monitor for updates or changes in available funding.
• Obtain required insurance prior authorizations for oral chemo and therapeutic medications; liaise with specialty/local pharmacies and pharmaceutical companies to coordinate medication delivery and provide status updates to patients.
• Serve as the oncology point of contact for patient billing questions and concerns; resolve SCC patient billing matters directly with Patient Financial Services (PFS) staff.
• Submit patient claims and applications for financial assistance in a timely and HIPAA-compliant manner; post received funds to the financial system and update patients on funding status.
• Liaise with pharmaceutical company representatives for IV and oral therapies to learn about products, copay programs, and foundation assistance; communicate updates to the clinical team.
• Serve as an integral member of the SCC front office team, providing coverage and assistance as needed.
• Attend weekly Chartrounds meetings with clinical staff and communicate pertinent patient information regarding treatment plans and urgent needs.
• Role model the principles of a Just Culture and Organizational Values while maintaining HIPAA compliance.

Requirements

• 3 years of experience in a healthcare setting required.
• Previous oncology-specific financial navigation or financial counseling experience preferred.
• Experience working in an oncology setting preferred.

Qualifications

• Bachelor’s Degree in healthcare or a related field.

Benefits

• Competitive Wages & Family Benefits:
  • Competitive wages
  • 4 weeks paid parental leave
  • Housing programs
  • Childcare reimbursement
• Comprehensive Health Benefits:
  • Medical
  • Dental
  • Vision
• Educational Programs:
  • Tuition Assistance
  • Existing Student Loan Repayment
  • Specialty Certification Reimbursement
  • Annual Supplemental Educational Funds
• Paid Time Off:
  • Up to five weeks in your first year of employment, increasing annually.
• Retirement & Supplemental Insurance:
  • 403(b) Retirement plan with immediate matching
  • Life insurance
  • Short- and long-term disability
• Recreation Benefits, Wellness & More:
  • Up to $1,000 annual wellbeing reimbursement
  • Recreation discounts
  • Pet insurance

Pay

Hourly pay ranges from $22.60 USD to $29.67 USD, based on relevant education and experience.