Bilingual Case Manager

Role Overview

• 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.
• Additional duties as requested by the Manager.

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
• Experience in oncology, rare disease considered 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