[Hiring] FACET Clinical Coordinator @Cubic Health

Role Description

FACET is a unique Prior Authorization offering for complex health conditions that Cubic manages for clients across Canada. It is an independent, evidence-based program that manages claims for high-cost specialty drugs at the disease-state level to ensure optimal use of drug plan resources while ensuring the best health outcomes for members of the plans we serve. As a member of Cubic’s FACET Prior Authorization team, you will be supporting a team of Clinical Pharmacists who are managing requests for these medications from Specialists across the country.

Primary Accountabilities

• Assisting in the coordination, management and clinical adjudication of Prior Authorization claims through the Employer’s FACET Program including interacting with plan members, physicians, other healthcare professionals and patient support program representatives.
• Managing, processing, and evaluating renewal claims based on established clinical criteria, ensuring coordination with secondary payers/provincial drug programs where applicable.
• Facilitate the claim review process between the administrative and pharmacist teams (triage of incoming claims, rendering initial decisions, etc.).
• Supporting clients in answering appropriate information requests (by phone, e-mail, fax, or mail).
• Assisting in the administrative operations of the FACET Program.
• Assisting with the development and maintenance of FACET evidence base.

Qualifications

• Registered Nurses (RNs) or Registered Practical Nurses (RPNs) or Nurse Practitioners (NPs) or Registered Pharmacy Technicians (RPhTs) are welcome to apply.
• At least two years of experience in related role (e.g. EAP, Prior Authorization background).

Requirements

• Excellent written and verbal communication skills: verbal and written fluency in English, written fluency in French is an asset.
• Excellent customer service skills to optimally service our valued plan members.
• Proficient computer skills including competency with MS Word and Outlook.
• Excellent time management skills and ability to prioritize work.
• Attention to detail and strong organizational skills with the ability to multi-task.
• Ability to take the initiative to complete necessary tasks.

Benefits

• Competitive salary.
• Remote work option after probation period.
• Annual License Fee Reimbursement.
• Stipend for Home Office Equipment.
• Flexible benefits with Healthcare Spending Account.