Clinical Financial Navigator

Trinity Health•Grand Rapids, MI

1d•Onsite

About The Position

The Clinical Financial Navigator is a specialized resource for oncology and outpatient infusion patients, combining clinical expertise with knowledge of health insurance, reimbursement, and financial assistance programs. The role reduces financial barriers to care by identifying insurance optimization opportunities, coordinating access to assistance programs, and proactively addressing financial toxicity. Using knowledge of disease states, treatment plans, and therapeutic goals, the navigator works with patients, providers, and multidisciplinary team members to support timely treatment access while minimizing out-of-pocket expenses and maximizing reimbursement opportunities. The position assesses patient financial needs, reviews insurance coverage and anticipated care needs, educates patients about coverage and financial resources, and connects eligible patients with assistance programs. It also serves as a subject matter expert for complex cases, supports revenue-cycle improvement, tracks and presents financial outcomes, and maintains accurate documentation. The role is based in Grand Rapids, Michigan, and is full-time on the day shift.

Requirements

Master's degree in a clinical healthcare field is required.
Current, unrestricted professional licensure in the State of Michigan related to the clinical discipline is required.
At least seven years of combined experience in clinical healthcare practice and health insurance, reimbursement, financial counseling, financial navigation, revenue cycle, or related healthcare financial services.
Extensive knowledge of oncology and infusion treatment processes.
Strong understanding of health insurance plans, benefits, reimbursement, and payer requirements.
Expertise in insurance optimization and financial assistance resources.
Understanding of patient financial toxicity and strategies to reduce barriers to care.
Knowledge of revenue-cycle operations and reimbursement methodologies.
Excellent analytical, problem-solving, and critical-thinking skills.
Strong interpersonal, communication, and customer service skills.
Ability to educate patients, families, and interdisciplinary team members effectively.
Strong organizational skills and ability to manage multiple complex cases simultaneously.
Proficiency with electronic medical records and healthcare financial systems.
Ability to present financial and operational data to leadership audiences.

Nice To Haves

Oncology experience is strongly preferred.
Experience in a cancer center, infusion center, or specialty care setting.
Certification or advanced training in financial navigation, revenue cycle, reimbursement, or oncology services.
Experience reporting outcomes and presenting data to executive leadership.

Responsibilities

Assess the financial needs of oncology and outpatient infusion patients, including insurance coverage, diagnoses, treatment plans, and anticipated care needs.
Use clinical knowledge of disease processes and treatment regimens to identify insurance coverage and financial assistance opportunities.
Analyze and optimize insurance benefits to reduce patient financial burdens and support treatment affordability.
Educate patients about insurance optimization strategies, coverage options, and available financial resources.
Identify qualifying patients and connect them with external assistance programs, copay assistance, grants, and other financial support services.
Anticipate and address financial toxicity concerns before they negatively affect patient care or treatment adherence.
Collaborate with physicians, nurse navigators, social workers, financial navigators, revenue-cycle teams, and other interdisciplinary care team members.
Provide guidance and support to the Financial Navigation Team on complex insurance and financial assistance cases.
Maintain current knowledge of insurance regulations, reimbursement methodologies, patient assistance programs, and oncology-related financial resources.
Apply knowledge of the healthcare revenue cycle and support initiatives to improve reimbursement and patient access.
Collect, analyze, and report quarterly metrics related to patient savings, reimbursement recovery, and financial outcomes.
Serve as an active member of the Cancer Service Line Revenue Cycle Committee.
Present financial outcome data, trends, and recommendations to department and senior leadership.
Participate in continuing education and professional development activities.
Maintain accurate and timely documentation in accordance with organizational policies and regulatory requirements.
Perform other duties as assigned.