About the role

  • Bilingual Case Manager managing patient enrollment and reimbursement processes for a pharmaceutical support provider in Canada. Collaborating with patients, insurers, and physicians to facilitate access to treatment.

Responsibilities

  • Responsible for the timely enrollment of the patient into the Patient Support Program.
  • Collaborate with the patient, insurer and physician regarding the documentation necessary for maximal reimbursement coverage, including the investigation of all public and private insurers and supporting employer escalations as required.
  • Reviews patient status and assists the prescribing physician to prepare documentation for public or private coverage by reviewing patient charts, assessing previous therapies and tests.
  • Provides therapy guidelines/education on the program to manage patient and physician expectations.
  • Collects information and conducts patient financial assessment eligibility based on program guidelines.
  • Ensures patient services are coordinated and tracked in a timely manner resulting in quick and continued access to therapy.
  • Reports Adverse Events / Severe Adverse Events (AE / SAEs) following approved SOPs.
  • Maintain service levels in case management, including telephone answer rates, time to initial contact with the patient, Adverse Events reported within twenty-four hours of receipt and any other KPIs established as the Program level.
  • Electronically updates the Customer Relationship Management (CRM) tool by providing timely patient and clinic information.
  • Fosters and promotes a spirit of teamwork while working with internal patient support teams.
  • Acts a liaison and provides ongoing feedback to the Program Manager based-on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance.
  • Identifies obstacles to obtaining coverage and channels this information to the Program Manager and/or Assistant Program Manager.
  • Completes all relevant reports (time sheets, expenses, mileage, validate CRM reports, etc.) as per specified timelines and as per required standards.

Requirements

  • A Bachelor’s degree
  • 2-3 years of experience in Patient Support Program
  • Bilingualism (English and French) is required
  • Experience with reimbursement billing, special access, the appeals process, and conducting field-based reimbursement support and consultation is an asset
  • Knowledge of private and public reimbursement structure, systems, and the process is an asset
  • Advanced knowledge of the pharmaceutical distribution industry
  • Must be able to work from home and have a quiet, private home office space
  • Strong analytical skills including interpretation of regulation and legislation
  • Excellent customer service, problem-solving, and conflict resolution skills
  • Effective interpersonal skills
  • Typing skills and ability to be a strong functional user of various computer-based programs

Benefits

  • Competitive Salary and generous vacation entitlement
  • Wellness Program (5 paid days off for your well-being!)
  • Paid Sick Days
  • Competitive Benefits Package including Dental & Extended Health Benefits, AD&D, LTD & Employee/Dependent Life Insurance
  • Employee & Family Assistance Program
  • RRSP Matching Program

Job title

Job type

Full Time

Experience level

JuniorMid level

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

RemoteCanada

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