Unit Claims Manager leading Accident Benefits operations at Intact, a Canadian insurer. Coaching claims teams, improving processes, auditing quality, and driving compliance and performance.
About the role
- Senior Case Manager managing enrollment, reimbursement, and therapy access for Sentrex Health Solutions’ pharmaceutical patient support programs. Delivering case management, CRM expertise, and training remotely across Canada.
Responsibilities
- Deliver high-level case management, training, and support services across programs and departments
- Manage patient enrollment, reimbursement processes, and service coordination
- Provide drug coverage support to physicians and patients
- Follow up on private and provincial drug-plan coverage submissions
- Ensure timely and continued patient access to prescribed therapies
- Coordinate with patients, insurers, physicians, and internal patient support teams
- Review patient charts, previous therapies, and tests to support coverage documentation
- Provide therapy guidelines and program education
- Conduct patient financial eligibility assessments
- Track patient services and maintain case-management service levels and KPIs
- Report adverse events and severe adverse events according to approved SOPs
- Update CRM with patient and clinic information
- Provide feedback to the Associate Program Manager and identify coverage obstacles
- Provide backup support to PSP Supervisors, Associate Program Managers, and Program Managers
- Participate in PSP team and client meetings
- Complete reports, timesheets, expenses, mileage, and CRM validation
- Create and maintain work instructions and training documents
- Support program pre- and post-launch activities
- Deliver training content and facilitate in-person and virtual learning sessions
- Manage multiple projects with tight deadlines and improve processes
- Serve as a subject matter expert for CRM and case management
- Shadow case managers and provide training and support
- Provide ad hoc support, data cleanup, and other duties requested by PSP Management
Requirements
- Bachelor’s Degree or College Diploma in a relevant field of study
- 2–5 years of experience in Patient Support Programs with advanced knowledge of Case Management and the pharmaceutical distribution industry
- Advanced knowledge of reimbursement billing, special access, appeals process, and field-based reimbursement support and consultation
- Must be able to work from home with a quiet, private home office space
- Excellent verbal and written communication skills in English
- Knowledge of private and public reimbursement structures, systems, and processes
- Strong analytical skills, including interpretation of regulation and legislation
- Excellent customer service, problem-solving, and conflict resolution skills
- Strong interpersonal skills
- Strong functional user of various computer-based programs
- Proficiency in Adobe Acrobat, SharePoint, and Microsoft Office applications
- Ability to consistently meet deadlines and prioritize projects
- Exceptional organizational skills
- Ability to establish and build healthy working relationships and partnerships with peers
- Ability to work independently, make decisions, multitask, and solve problems under pressure
- Flexible, resourceful, creative, and proactive work style
- Results-oriented with ability to handle multiple tasks and maintain high performance
- Advanced ability to learn and understand new systems and software quickly
- Bilingualism (English and French) considered a strong asset
Benefits
- State-of-the-art facilities to provide high-quality products and services
- Opportunity to be part of a winning, high-performing team
- Collaborative, engaging workplace culture
- Flexible working environment promoting healthy work-life balance
- Diverse and inclusive culture
- Employee Development Program
- Industry-leading, in-house corporate training
- Competitive salary
- Generous vacation entitlement
- Wellness Program with 5 paid days off for well-being
- Paid sick days
- Competitive benefits package including dental and extended health benefits, AD&D, LTD, and employee/dependent life insurance
- Employee & Family Assistance Program
- RRSP Matching Program
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