RN IBD Navigator - WHMG Gastroenterology - Full Time Days

Position Summary

This position provides specialized clinical coordination and support for patients with inflammatory bowel disease (IBD) receiving biologic therapy. This role facilitates the biologic treatment process by coordinating referrals, managing prior authorizations, assisting with specialty pharmacy and infusion center communication, and supporting patient access to medication assistance programs. The IBD Navigator provides patient education, monitors therapy processes, maintains patient tracking data, and collaborates closely with providers, infusion centers, specialty pharmacies, and internal clinical staff to ensure timely, coordinated, and high-quality care for IBD patients.

Position Requirements

Formal Education / Training:

Earned a nursing diploma or degree from a college or university

Licensed by the State of Tennessee

Workplace Experience:

At least one year of experience in a medical office environment. Word/Excel helpful

Equipment and Skills Training:

Standard patient care equipment for services provided and injectable medicines. Computer- ability to create Word documents and Excel spreadsheets beneficial. Ability to work well under pressure, function independently, strong organizational skills, problem solve/critical thinking skills, strong communication skills and capability of multi-tasking.

Physical Environment:

Outpatient clinic whose patient population ranges consists of adults ≥ 18 yrs of age

Physical Effort:

Must be able to sit, stand, communicate, in English, both orally and in writing and lift over 20 pounds.

Key Results

Initiates biologic therapy process for IBD patients as ordered by provider, including completing infusion center referral forms, gathering required clinical documentation, and submitting referrals in a timely manner.

Reviews biologic therapy packet with patients, providing education on the referral process and shared clinic/patient responsibilities. Demonstrates use of pen injector samples when applicable.

Notifies provider of biologic renewal prescriptions when due and submits prescriptions to appropriate specialty pharmacy or completes renewal orders to infusion center. Verifies pharmacy insurance coverage, ensures specialty pharmacy information is updated in the medical record when insurance changes occur.

Completes initial and renewal prior authorizations for biologic maintenance therapies for new and established patients. Drafts appeal and medical necessity letters for provider review and approval in cases of authorization denial.

Coordinates, completes and submits Patient Assistance Program paperwork for eligible patients to biologic medication drug company.

Communicates urgent patient condition or therapy-related issues to provider in a timely manner. Implements provider orders related to biologic therapy and patient care.as directed by provider.

Maintains and updates IBD biologic patient tracking spreadsheets.

Administers Hepatitis B vaccines to IBD patients. Assists with provider clinics as needed. Performs additional clinical duties as assigned by manager.

Maintains coordination and assembly of IBD Biologic Patient Education packets.

Triages IBD nurse line calls and patient portal messages in a timely manner. Documents accurately and fosters positive working relationships with IBD patients.

Coordinates referrals to other GI specialty clinics as directed by practitioner

Monitors IBD clinic processes for quality improvement. Identifies and develops recommendations for change to practitioners when issues are identified. Initiates approved changes in process.

Establishes and maintains collaborative relationships with biologic drug representatives, infusion center representatives, clinic nurses, and office staff to optimize patient care and experience.