Bilingual Case Manager – East Coast

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 collaboratively with patients, insurers, and physicians to ensure all necessary documentation is in place for optimal reimbursement coverage, including investigating public and private insurers and supporting employer escalations as necessary.

• Review patient statuses and assist prescribing physicians in preparing documentation for public or private coverage by evaluating patient charts and assessing prior therapies and tests.

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

• Gather information and conduct financial assessments for patient eligibility in accordance with program guidelines.

• Ensure that patient services are coordinated and tracked promptly, facilitating quick and continued access to therapy.

• Report Adverse Events / Severe Adverse Events (AE / SAEs) following established Standard Operating Procedures (SOPs).

• Maintain case management service levels, including telephone response rates, time to initial patient contact, reporting of Adverse Events within twenty-four hours of receipt, and any other Key Performance Indicators (KPIs) set at the Program level.

• Update the Customer Relationship Management (CRM) tool electronically with timely patient and clinic information.

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

• Serve as a liaison and provide ongoing feedback to the Program Manager based on field observations and customer feedback regarding 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.

• Complete all relevant reports (timesheets, expenses, mileage, validate CRM reports, etc.) within specified timelines and according to required standards.

• Perform additional duties as assigned by the Manager.

⛳️ Requirements

• A Bachelor’s degree.

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

• Bilingualism in English and French is mandatory.

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

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

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

• Advanced knowledge of the pharmaceutical distribution industry.

• Must be able to work remotely and possess a quiet, private home office space.

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

• Excellent customer service, problem-solving, and conflict resolution capabilities.

• Effective interpersonal communication skills.

• Proficient typing skills and competency in using various computer-based programs.

🏝️ Benefits

• Competitive salary along with generous vacation entitlement.

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

• Paid sick days.

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

• Employee & Family Assistance Program.

• RRSP matching program.