Clinical Financial Navigator

Location: Mercy Health West Michigan Hospital Campus - Grand Rapids, Mi

Employment Type:

Full time

Shift:

Day Shift

Description:

Clinical Financial Navigator (Oncology & Infusion Services)

Position Title: Clinical Financial Navigator
Department: Oncology/Outpatient Infusion Services
Location: Grand Rapids, Michigan
Employment Type: Full-Time

Position Summary

The Clinical Financial Navigator serves as a highly specialized resource for oncology and outpatient infusion patients by combining advanced clinical expertise with extensive knowledge of health insurance, reimbursement, and financial assistance programs. This role is responsible for reducing financial barriers to care by identifying insurance optimization opportunities, coordinating access to assistance programs, and proactively addressing financial toxicity concerns.

Leveraging clinical knowledge of disease states, treatment plans, and therapeutic goals, the Clinical Financial Navigator partners closely with patients, providers, and multidisciplinary team members to ensure patients receive timely access to treatment while minimizing out-of-pocket expenses and maximizing reimbursement opportunities.

The ideal candidate is passionate about improving access to care, possesses exceptional analytical and communication skills, and is committed to supporting patients through complex financial and clinical healthcare challenges.

Essential Duties and Responsibilities

• Assess the financial needs of all oncology and outpatient infusion patients, including review of insurance coverage, diagnosis, treatment plans, and anticipated care needs.
• Utilize advanced clinical knowledge and understanding of disease processes and treatment regimens to identify optimal insurance coverage and financial assistance opportunities.
• Analyze and optimize insurance benefits to reduce patient financial burdens and support treatment affordability.
• Educate patients regarding insurance optimization strategies, coverage options, and available financial resources.
• Identify and connect qualifying patients with external assistance programs, copay assistance programs, grants, and other financial support services.
• Proactively anticipate and address potential financial toxicity concerns before they negatively impact patient care or treatment adherence.
• Collaborate with physicians, nurse navigators, social workers, financial navigators, revenue cycle teams, and other members of the interdisciplinary care team.
• Function as a subject matter expert for the Financial Navigation Team, providing guidance and support regarding complex insurance and financial assistance cases.
• Maintain current knowledge of insurance regulations, reimbursement methodologies, patient assistance programs, and oncology-related financial resources.
• Demonstrate extensive knowledge of the healthcare Revenue Cycle and actively support initiatives to improve reimbursement and patient access.
• Collect, analyze, and report quarterly metrics related to patient savings, reimbursement recovery, and financial outcomes generated through this role.
• 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.

Minimum Qualifications

Education

• Master's degree in a clinical healthcare field required.
• Preferred disciplines include: Nursing Social Work Other closely related clinical healthcare fields

Licensure/Certification

• Current and unrestricted professional licensure in the State of Michigan related to clinical discipline required.
• Examples include: Registered Nurse (RN) Licensed Master Social Worker (LMSW)

Experience

• Minimum of seven (7) years of combined experience in: Clinical healthcare practice, and Health insurance, reimbursement, financial counseling, financial navigation, revenue cycle, or related healthcare financial services

Knowledge, Skills, and Abilities

• Extensive knowledge of oncology and infusion treatment processes.
• Strong understanding of health insurance plans, benefits, reimbursement, and payer requirements.
• Demonstrated 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.
• Outstanding interpersonal, communication, and customer service skills.
• Ability to effectively educate patients, families, and interdisciplinary team members.
• Strong organizational skills with the 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.

Preferred Qualifications

• Oncology experience strongly preferred.
• Experience working within 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.

Why Join Us?

At Trinity Health, we are committed to ensuring every patient has access to the care they need. The Clinical Financial Navigator plays a critical role in removing financial barriers, improving patient outcomes, and supporting our mission of delivering compassionate, person-centered care.

Join a collaborative team dedicated to helping patients navigate complex healthcare and financial challenges while making a meaningful impact in their lives every day.

Please completely fill out the application and upload resume.

This is required to be considered, including internal candidates.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.