Bilingual Case Manager

📋 Description

• Accountable for the prompt enrollment of patients into the Patient Support Program.

• Collaborate with patients, insurers, and physicians to ensure all documentation is in place for optimal reimbursement coverage, including thorough investigations of public and private insurers and supporting employer escalations as necessary.

• Review patient status and assist the prescribing physician in preparing documentation for public or private coverage by evaluating patient charts and previous therapies and tests.

• Provide therapy guidelines and education on the program to manage expectations for both patients and physicians.

• Gather information and conduct patient financial assessments to determine eligibility based on program guidelines.

• Ensure timely coordination and tracking of patient services, facilitating quick and continued access to therapy.

• Report Adverse Events/Severe Adverse Events (AE/SAEs) in accordance with approved Standard Operating Procedures (SOPs).

• Maintain service levels in case management, including metrics such as telephone response rates, time to initiate patient contact, and reporting of Adverse Events within twenty-four hours of receipt, along with any other Key Performance Indicators (KPIs) established at the Program level.

• Update the Customer Relationship Management (CRM) tool electronically, ensuring timely patient and clinic information is provided.

• Encourage and promote teamwork while collaborating with internal patient support teams.

• Serve as a liaison and provide continuous feedback to the Program Manager based on field observations and customer feedback regarding service quality, training, and other critical areas.

• Identify barriers to obtaining coverage and relay this information to the Program Manager and/or Assistant Program Manager.

• Complete all relevant reports (timesheets, expenses, mileage, validate CRM reports, etc.) in accordance with specified timelines and required standards.

• Coordinate cases with insurance companies, physicians, and healthcare professionals to enhance reimbursement solutions.

• Assist patients in navigating the insurance landscape, guiding them in finding insurance forms, obtaining signatures, and submitting documents to their insurers for responses.

• Prepare, organize, and submit all necessary documentation to insurance providers and public/federal funding programs.

• Perform additional duties as assigned by the Manager.

⛳️ Requirements

• A Bachelor’s degree is required.

• 2-3 years of experience in a Patient Support Program.

• Bilingual proficiency in English and French is mandatory.

• Experience with reimbursement billing, special access, the appeals process, and field-based reimbursement support and consultation is advantageous.

• Familiarity with the private and public reimbursement structure, systems, and processes is beneficial.

• Experience in oncology or rare diseases is considered an asset.

• Advanced understanding of the pharmaceutical distribution industry.

• Must have the ability to work from home and maintain a quiet, private office environment.

• Strong analytical skills, including the ability to interpret regulations and legislation.

• Exceptional customer service, problem-solving, and conflict resolution abilities.

• Effective interpersonal skills are essential.

• Proficient typing skills and the capability to be a competent user of various computer-based programs.

🏝️ Benefits

• Competitive salary and generous vacation entitlement.

• Wellness Program offering 5 paid days off for your well-being!

• Paid Sick Days.

• Comprehensive Benefits Package, including Dental & Extended Health Benefits, AD&D, LTD, and Employee/Dependent Life Insurance.

• Employee & Family Assistance Program.

• RRSP Matching Program.