Senior Caseworker – Bilingual, French

Role Overview

• Working closely with assigned patients’ to identify various reimbursement coverage options and investigate financial options for those without insurance.
• Assist with the coaching and mentoring of existing team members.
• Manage a patient caseload larger than their caseworker counterparts.
• Be a reimbursement expert in assigned caseload territory.
• Provides other caseworker(s) assistance with complex reimbursement, insurance, benefit investigation, special authorization, and appeal requests.
• Participate in special projects as assigned by the Program Manager.
• Provide daily support to Associate Program Manager(s)
• Assist management with various reports and program related tasks.
• Work with management to develop program protocol and SOP for Caseworker role.
• With management, lead training of new caseworkers, including but not limited to shadowing & call monitoring.
• Regularly Interacts with insurance companies, physician' offices, and healthcare professionals to provide optimal reimbursement support
• Assists the patient with Clinic and Pharmacy selections, and schedules patient appointments
• Generates drug orders ensuring that required information is faxed to the pharmacy, and related parties
• Adherence to the general company processes.
• Telephone Support : Implementing call-centre programs including the provision of patient, healthcare professional and funding bodies with telephone support.
• Current assistance lines focus on: Funding and access issues, including private, public and special access programs; Compliance programs
• Administer and adhere to case-management protocols, including clinical monitoring, data collection, on-going patient follow-up, compliance, therapy disruption/discontinuation monitoring, adverse event reporting and liaison with primary healthcare providers;
• Implementing pharmaceutical and biotechnology related market research initiatives with physicians, patients, pharmacists or other allied health professionals;
• All patient programs are based on casework methods and include a significant amount of out-bound calls.
• Document each activity in program specific database.
• Participate and attend on-going refresher training and in specialized training courses for specific products or programs as deemed appropriate by the manager.
• Clear communication to manager, pod, and program trained colleagues regarding the management of cases during foreseen absences.
• Responsible to report all Adverse Events to the assigned units/departments

Requirements

• Minimum University Degree in a related field or equivalent
• A minimum of two (2) years experience in customer service; experience in medical, pharmaceutical and/or insurance industry is an asset
• Bilingual in French and English: written and verbal is required
• Highly organized with strong attention to detail
• Strong proficiency in Microsoft applications (Outlook, Word, Excel & PowerPoint)
• Flexibility in working shifts (hours of operation are 8 am
• 8pm)
• Ability to apply critical thinking skills in order to solution problems
• A Minimum of 2 years experience working for a patient support program
• Experience working in a call center environment an asset
• Strong communication and interpersonal skills: written and verbal including effective phone etiquette to diverse audiences

Benefits

• medical, dental, and vision care
• backup dependent care
• adoption assistance
• infertility coverage
• family building support
• behavioral health solutions
• paid parental leave
• paid caregiver leave
• training programs
• professional development resources
• mentorship programs
• employee resource groups
• volunteer activities