Bilingual Case Manager

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

📋 Description

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

• Work in collaboration with the patient, insurance provider, and physician to ensure all necessary documentation is submitted for optimal reimbursement coverage, including investigating all public and private insurers and facilitating employer escalations as needed.

• Evaluate patient status and assist the prescribing physician in preparing documentation for public or private coverage by reviewing patient records and assessing prior therapies and tests.

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

• Gather information and perform financial eligibility assessments for patients based on program criteria.

• Ensure that patient services are coordinated and monitored promptly to facilitate swift and sustained 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, which includes telephone answer rates, prompt initiation of patient contact, reporting of Adverse Events within twenty-four hours of receipt, and adherence to any other KPIs set at the Program level.

• Update the Customer Relationship Management (CRM) tool electronically by providing timely information related to patients and clinics.

• Encourage and promote a collaborative spirit while engaging with internal patient support teams.

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

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

• Perform additional duties as assigned by the Manager.

⛳️ Requirements

• Post-secondary education with relevant healthcare experience is advantageous.

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

• Bilingualism in English and French is mandatory.

• Experience in the field of oncology is a plus.

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

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

• Must be capable of working from home with a quiet and 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 knowledge of the pharmaceutical distribution sector.

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

• Effective interpersonal abilities.

• Proficient typing skills and a strong functional user of various computer applications.

🏝️ Benefits

• Competitive salary along with generous vacation entitlement.

• Wellness program offering 5 paid days off for personal well-being!

• Paid sick days available.

• Comprehensive benefits package that includes dental and extended health benefits, AD&D, LTD, and employee/dependent life insurance.

• Employee and Family Assistance Program.

• RRSP matching program.