Reimbursement Specialist, Rare Diseases

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

📋 Description

• Engage in daily and ongoing communication with the Program Manager and Associate Program Manager regarding both new and ongoing projects.

• Exhibit a comprehensive understanding of rare disease program offerings, including the pathophysiology of the disease/product, therapeutic areas, disease processes, and mechanisms of action; as well as the application of rare disease Standard Operating Procedures (SOPs).

• Demonstrate extensive knowledge of public/private and federal funding mechanisms, along with Rare Disease funding organizations in the US and Canada.

• Coordinate cases with physicians and healthcare professionals to prepare submissions that meet the specific specifications and criteria set by public/private payers.

• Oversee all aspects necessary to secure prescription drug coverage for patients.

• Manage coordination with insurance companies, physician offices, and healthcare professionals to enhance reimbursement solutions.

• Navigate the complex lobbying process to secure prescription drug coverage and reimbursement for these essential and costly medications.

• Organize documents, submissions, and all required paperwork for insurance companies and public/federal funding programs.

• Implement Financial Means Tests as needed to optimize patients' prescription drug coverage.

• Coordinate pharmacy processes after funding has been successfully obtained.

• Responsible for reporting all Adverse Events to the designated units or departments.

• The Reimbursement Specialist may also be assigned additional duties and tasks as necessary from time to time.

⛳️ Requirements

• A minimum of 3 years of experience in the pharmaceutical, insurance, or healthcare-related fields is required.

• Prior experience in reimbursement, along with knowledge of public, private, and federal reimbursement processes, is essential.

• At least three (3) years of experience in a Customer Service environment.

• Alternatively, a minimum of five (5) years in a role as a Senior Reimbursement Specialist.

• Professional, courteous, and efficient telephone communication skills are necessary.

• Strong proficiency in Microsoft applications, including Outlook, Word, and Excel.

• Proven ability to manage time effectively, set priorities, and multi-task to meet various competing deadlines.

• Excellent communication and interpersonal skills, particularly the ability to discuss sensitive topics with patients in a healthcare setting.

• Capability to work both independently and collaboratively within a team environment.

• Strong attention to detail is required.

• Bilingualism in French and English is considered an asset.

🏝️ Benefits

• Health insurance

• Dental care

• Vision care

• Backup dependent care

• Adoption assistance

• Infertility coverage

• Family building support

• Behavioral health solutions

• Paid parental leave

• Paid caregiver leave

• Professional development opportunities

• Mentorship programs

• Employee resource groups

• Volunteer activities