Bilingual Case Manager

This is a fully remote position, open to applicants in Canada.

📋 Description

• Oversee all facets of patient enrollment, reimbursement procedures, and service coordination for prescribed therapies.

• Offer drug coverage assistance to both physicians and patients.

• Follow up on submissions to private and provincial drug plans.

• Guarantee prompt patient access to prescribed treatments.

• Collaborate with patients, insurers, and physicians to ensure documentation is complete for optimal reimbursement coverage.

• Investigate public and private insurers and assist with employer escalations.

• Review patient charts, prior therapies, and tests to help physicians with coverage documentation.

• Provide therapy guidelines and educational support to patients and physicians.

• Gather information and conduct assessments of patient financial eligibility.

• Coordinate and monitor patient services to ensure timely and ongoing therapy access.

• Report Adverse Events and Severe Adverse Events according to approved Standard Operating Procedures (SOPs).

• Maintain case management service levels and meet established Key Performance Indicators (KPIs).

• Update the Customer Relationship Management (CRM) tool with patient and clinic data.

• Collaborate with internal patient support teams.

• Provide field insights to the Program Manager regarding service quality, training, and other critical areas.

• Identify coverage challenges and escalate information to the Program Manager or Assistant Program Manager.

• Complete timesheets, expenses, mileage, and CRM reports within required deadlines.

• Perform additional tasks as requested by the Manager.

⛳️ Requirements

• Post-secondary education with a minimum of 2 years of experience in healthcare.

• 1-2 years of experience in a Patient Support Program is advantageous.

• Bilingualism in English and French is mandatory.

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

• Knowledge of private and public reimbursement structures, systems, and processes is an asset.

• Experience in oncology is a plus.

• Must be capable of working from home and possess a quiet, private home office environment.

• Exceptional verbal and written communication skills in both English and French.

• Strong analytical abilities, including the interpretation of regulations and legislation.

• Advanced understanding of the pharmaceutical distribution sector.

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

• Effective interpersonal skills.

• Proficient typing skills and ability to be an adept user of various computer-based applications.

• Availability to work Monday through Friday, within rotating shifts from 8:00 am to 8:00 pm EST.

🏝️ Benefits

• State-of-the-art facilities to deliver high-quality products and services.

• Flexible work environment that encourages a healthy work-life balance.

• Opportunities for learning and growth through an Employee Development Program.

• Industry-leading, in-house corporate training available throughout the year.

• Competitive salary.

• Generous vacation entitlement.

• Wellness Program providing 5 paid days off for 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.

• Remote work arrangement.

• Commitment to equal opportunity, diversity, inclusion, belonging, equity, and accessibility.

• Accommodations available upon request during the selection process.