Lead Patient Navigator Social Worker - PBM (Remote/Hybrid)

Salary: USD68640 - USD83200 per year Client Location: Bethesda, MD Work Location: Remote, however travel is required approx. 25% of the year nationally. Job Description: Are you ready to give your career a boost by bringing your talents and expertise to some of the nation’s top companies? At Medix, we are dedicated to creating opportunities for talent through our Healthcare, Scientific and Information Technology divisions. Our dedicated recruiters offer a personalized service to make sure we truly understand your employment needs. Our client is seeking a MSW individual to guide a team of field-based Social Workers while actively driving patient access and reimbursement support within a "Hub - Pharmacy Benefits Management" setting. This individual will need to representa a true "player/coach" and not be afraid to roll up their sleeves. They will manage their own caseload (~10% of volume), fill operational gaps, and step in to cover shifts when needed. **This is a direct hire employment opportunity** Responsibilities/ Job Duties: Manage a team of 3 field-based Case Managers. Lead regular 1-on-1s, set performance goals (MBOs), deliver evaluations, and handle performance management or disciplinary actions. Maintain a direct caseload (~10% of standard case volume), supporting complex patient access cases, insurance navigation, and ongoing therapy compliance. Work directly with patients, providers, specialty pharmacies, and HUB teams to resolve Benefits Verifications (BVs), Prior Authorizations (PAs), and insurance/Medicare issues. Act as a hands-on lead by covering shifts, stepping in during volume spikes, and filling in for team absences across the 9 AM – 9 PM EST window. Partner with field sales reps and market access teams to educate field personnel and align regional access performance with overarching program goals Minimum Education and Experience Requirements: Master of Social Work (MSW) required (active state license is not required). 5–7+ years working within a pharma HUB or reimbursement environment (10+ years strongly preferred). 3–5+ years of team lead, supervisory or management experience (true leader, handling 1-on-1s, evaluations, disciplinary conversations). Hands-on clinical social work experience within the last 10 years (e.g., hospital, nursing home, direct patient counseling). Strong working knowledge of BVs, PAs, Medicare, and specialty pharmacy workflows. Willingness to maintain a flexible schedule between 9:00 AM – 9:00 PM EST and travel up to 25% nationally. Schedule/ Shift: M-F, must be willing to work any shift/hours between 9am-9pm EST in addition to occassional overtime. #J-18808-Ljbffr Medix