Bilingual Reimbursement Specialist supporting coverage requests, case coordination, and reimbursement resolution. Cencora connects pharmaceutical manufacturers, providers, and patients to needed therapies.
About the role
- Bilingual Nurse Case Manager coordinating Canadian patient support programs for pharmaceutical therapies. Managing clinical follow-up, reimbursement, adherence, and patient-provider services remotely.
Responsibilities
- Coordinate and deliver services for Sentrex Health Solutions patient support programs
- Manage all aspects of assigned program support and act as the primary point of contact for assigned healthcare providers
- Ensure patients have access to support programs and drug therapy
- Interact with patients, insurance companies, pharmacies, physicians, and other healthcare professionals to obtain medication coverage and manage patient cases
- Perform HCP and patient registration and enrolment activities
- Process and validate program data entry for accuracy and integrity
- Answer telephone and web-based inquiries about program services, disease states, and products
- Provide medical support, disease and therapy education, and disease management guidance
- Attend specialized therapy training sessions provided by pharmaceutical teams
- Provide inbound and outbound telephone support, including maintenance and adherence calls
- Administer case-management protocols, including clinical monitoring, data collection, follow-up, compliance, therapy disruption/discontinuation monitoring, and adverse-event reporting
- Work with reimbursement specialists and physicians to secure therapy funding and investigate alternative funding
- Attend patient meetings and conferences as needed
- Report adverse events to manufacturers and medical information teams and enter them into required systems within timelines
- Maintain confidentiality of patient, client, and corporate information
- Liaise with physicians’ offices, pharmacies, laboratories, infusion/injection service providers, and other parties to coordinate patient services and resolve issues
- Participate in continuing education activities
- Develop training materials and programs for new patient support program team members
- Schedule laboratory monitoring, facilitate coverage renewals and changes, and provide reimbursement support
- Review, analyze, and validate patient information for completeness and accuracy
- Schedule appropriate next steps to ensure continuity of service delivery
- Follow up and advocate until coverage decisions are received
- Support drug shipment requests
- Perform other duties assigned by the manager
Requirements
- Must be an RN or RPN in good standing with the College of Nurses of the respective province
- Experience in Patient Support Programs is required
- Reimbursement knowledge to obtain patient coverage is an asset
- Experience in Hepatitis is a strong asset
- Minimum 2 years of clinical experience is preferred
- Bilingualism in English and Mandarin is required
- Commitment to providing a high level of service to internal and external clients
- Adaptability and a track record of success during growth and organizational change
- Proven ability to develop trust and influence at multiple levels
- Impactful and candid communication style
- Exceptional organizational skills and ability to build effective working relationships with colleagues, management, and stakeholders
Benefits
- State-of-the-art facilities to provide high-quality products and services
- Collaborative, engaging workplace culture
- Flexible working environment that promotes a healthy work-life balance
- Diverse and inclusive culture
- Employee Development Program
- Industry-leading, in-house corporate training offered throughout the year
- Competitive Salary
- 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
- RRSP Matching Program
- Employee & Family Assistance Program
- Accommodations can be made available upon request for those candidates taking part in the selection process
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