[Hiring] Bilingual Senior Case Manager @Sentrex Health Solutions

Role Description

The Bilingual Senior Case Manager is responsible for delivering high-level case management, training, and support services to a variety of programs and departments at Sentrex Health Solutions.

• Manage all aspects of the enrollment, reimbursement process, and service coordination for patients prescribed the drug by health care practitioners.
• Provide drug coverage support to physicians and patients.
• Follow up on submissions for coverage through private and provincial drug plans.
• Ensure timely access to prescribed treatments for patients.
• Assist with program training needs and help develop and maintain required training.

A Day in the Life (What you will do here):

• Responsible for the timely enrollment of the patient into the Patient Support Program.
• Collaborate with the patient, insurer, and physician regarding documentation for maximal reimbursement coverage.
• Review patient status and assist prescribing physician in preparing documentation for coverage.
• Provide therapy guidelines/education to manage patient and physician expectations.
• Conduct patient financial assessment eligibility based on program guidelines.
• Ensure patient services are coordinated and tracked in a timely manner.
• Report Adverse Events / Severe Adverse Events (AE / SAEs) following approved SOPs.
• Maintain service levels in case management, including KPIs established at the Program level.
• Electronically update the Customer Relationship Management (CRM) tool with timely patient and clinic information.
• Foster teamwork while working with internal patient support teams.
• Act as a liaison and provide ongoing feedback to the Associate Program Manager.
• Provide back-up assistance to PSP Supervisors, Associate Program Managers, and Program Managers when required.
• Identify obstacles to obtaining coverage and communicate this to the Program Manager and/or Associate Program Manager.
• Recommend corrective actions to ensure deliverables are met.
• Collaborate and participate in PSP team and client meetings as necessary.
• Ensure access to therapy is expedited according to Program KPIs.
• Complete all relevant reports (time sheets, expenses, mileage, validate CRM reports, etc.) as per specified timelines.
• Responsible for the creation of work-instructions and training documents as required by the program.
• Aid with program pre and post launch activities.
• Update and revise training content based on ongoing business needs.
• Deliver training content and facilitate learning sessions in person and virtually.
• Manage multiple projects with tight deadlines while providing valuable input to enhance processes.
• Be a subject matter expert in CRM and Case Management for Patient Programs at Sentrex Health Solutions.
• Shadow case managers to provide training and support as needed.
• Provide ad-hoc support to multiple programs, teams, and departments.
• Assist with data clean-up as required.
• Provide additional support with other duties or projects as requested by PSP Management.

Qualifications

• A Bachelor’s Degree or College Diploma in a relevant field of study.
• Bilingualism (English and French) is required.
• 2-5 years of experience in Patient Support Programs with advanced knowledge of Case Management and the pharmaceutical distribution industry.
• Demonstrates an aptitude for continuous learning.
• Advanced knowledge of reimbursement billing, special access, the appeals process, and field-based reimbursement support is required.
• Excellent verbal and written communication skills in English.
• Knowledge of private and public reimbursement structure, systems, and processes is required.
• 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 is required.
• Strong ability to consistently meet deadlines and prioritize projects.
• Exceptional organizational skills and ability to manage activities effectively.
• Ability to establish and build healthy working relationships and partnerships.
• Ability to work independently, make decisions, multitask, and solve problems under pressure.
• Flexible, resourceful, creative, and proactive work style with an enthusiastic attitude.
• Results-oriented with the ability to handle multiple tasks and maintain high performance.
• Advanced ability to learn and understand new systems and software quickly.
• Excellent problem-solving skills: ability to resolve issues effectively and efficiently.

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.