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About the role
- Senior Case Manager coordinating patient enrollment, drug reimbursement, and therapy access for Sentrex Health Solutions’ Canadian pharmaceutical support programs. Delivering case management, CRM expertise, and training remotely.
Responsibilities
- Deliver high-level case management, training, and support services to various 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 patient access to prescribed treatments
- Provide ongoing patient support using available resources
- Assist with program training needs and develop and maintain training materials
- Enroll patients into the Patient Support Program in a timely manner
- Collaborate with patients, insurers, and physicians on documentation for reimbursement coverage
- Investigate public and private insurers and support employer escalations
- Review patient charts, previous therapies, and tests to assist physicians with coverage documentation
- Provide therapy guidelines and program education
- Conduct patient financial eligibility assessments
- Coordinate and track patient services
- Report Adverse Events and Severe Adverse Events according to approved SOPs
- Maintain case-management service levels and program KPIs
- Update the CRM with patient and clinic information
- Provide feedback to the Associate Program Manager on service quality, training, and field observations
- Provide backup assistance to PSP Supervisors, Associate Program Managers, and Program Managers
- Identify coverage obstacles and recommend corrective actions
- Participate in PSP team and client meetings
- Complete reports, timesheets, expenses, mileage, and CRM validation
- Create work instructions and training documents
- Support program pre-launch and post-launch activities
- Update training content and facilitate in-person and virtual learning sessions
- Manage multiple projects with tight deadlines
- Act as a subject matter expert for CRM and case management
- Shadow case managers to provide training and support
- Provide ad hoc support to programs, teams, and departments
- Assist with 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, the appeals process, and field-based reimbursement support and consultation
- Must be able to work from home and have 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 use of various computer-based programs
- Proficiency in Adobe Acrobat, SharePoint, and Microsoft Office applications
- Strong 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 a high degree of 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
- Excellent problem-solving skills
- Bilingualism (English and French) will be considered a strong asset
Benefits
- State-of-the-art facilities to provide high-quality products and services
- 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
- Employee & Family Assistance Program
- RRSP Matching Program
- Remote work arrangement
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