[Hiring] Bilingual Case Manager @Sentrex Health Solutions

Role Description

The Bilingual Case Manager is responsible for managing all aspects of the enrollment, reimbursement process, and service coordination for patients who have been prescribed the drug by physicians. The Bilingual Case Manager will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, and provide continuous support for patients through excellent communication skills and available resources.

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 the documentation necessary for maximal reimbursement coverage.
• Review patient status and assist the prescribing physician to prepare documentation for coverage.
• Provide therapy guidelines/education on the program to manage patient and physician expectations.
• Collect information and 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 telephone answer rates and time to initial contact with the patient.
• Electronically update the Customer Relationship Management (CRM) tool with timely patient and clinic information.
• Foster and promote a spirit of teamwork while working with internal patient support teams.
• Act as a liaison and provide ongoing feedback to the Program Manager.
• Identify obstacles to obtaining coverage and channel this information to the Program Manager.
• Complete all relevant reports as per specified timelines and required standards.
• Additional duties as requested by the Manager.

Qualifications

• 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, and the appeals process is an asset.
• Knowledge of private and public reimbursement structure, systems, and processes is an asset.
• Experience in oncology or rare disease is 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.

Requirements

• Your commitment to providing a high level of service to your internal and external clients.
• You are highly adaptable with a track record of success during times of growth and organizational change.
• You have a proven track record of developing trust and influence at multiple levels.
• You demonstrate an impactful and candid communication style.
• You have exceptional organizational skills with the ability to build effective working relationships with colleagues, management, and stakeholders.

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.