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 patients prescribed medications by healthcare providers.

• Offer drug coverage assistance to both physicians and patients.

• Track submissions for coverage through private and provincial drug insurance plans.

• Ensure prompt access for patients to prescribed therapies and deliver ongoing support.

• Quickly enroll patients into the Patient Support Program.

• Collaborate with patients, insurers, and physicians to manage documentation for reimbursement coverage.

• Investigate both public and private insurance options and assist with employer escalations.

• Review patient records, prior therapies, and tests to aid physicians in preparing coverage documentation.

• Provide therapy guidelines and program education to patients and healthcare professionals.

• Gather information and perform financial eligibility assessments for patients.

• Coordinate and monitor patient services for continued access to therapy.

• Report Adverse Events and Severe Adverse Events in accordance with established SOPs.

• Maintain service levels in case management and program KPIs.

• Update patient and clinic information in the CRM system.

• Work closely with internal patient support teams.

• Liaise with the Program Manager and provide ongoing field feedback.

• Identify and communicate coverage challenges to the Program Manager and/or Assistant Program Manager.

• Complete timesheets, expense reports, mileage logs, CRM documentation, and other necessary reports.

• Carry out additional responsibilities as assigned by the Manager.

⛳️ Requirements

• A bachelor’s degree is required.

• Bilingualism in English and French is considered an asset.

• Experience in reimbursement billing, special access, appeals processes, and field-based reimbursement support and consultation is advantageous.

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

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

• Exceptional verbal and written communication skills in English are essential.

• Strong analytical capabilities, including the ability to interpret 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 the ability to effectively use various computer-based applications.

• Availability to work Monday through Friday during operating hours of 8:00 am to 8:00 pm EST.

• No travel is necessary.

🏝️ Benefits

• A flexible work environment that encourages a healthy work-life balance.

• Employee Development Program.

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

• Competitive salary.

• Generous vacation entitlement.

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

• Paid Sick Days.

• Competitive benefits package, including Dental & Extended Health Benefits, AD&D, LTD, and Employee/Dependent Life Insurance.

• Employee & Family Assistance Program.

• RRSP Matching Program.