Senior Care Navigator

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

📋 Description

• Ensure cross-program coverage and continuity.

• Provide vacation, sick leave, and temporary coverage for Care Navigators across various Patient Support Programs (PSPs).

• Maintain continuity of patient care during coverage intervals, including prompt follow-up, documentation, reimbursement activities, and adherence to program-specific KPIs.

• Quickly grasp and implement diverse program workflows, escalation paths, client expectations, and reporting requirements.

• Support special projects and operational initiatives.

• Offer focused assistance for special projects within the PSP, including process enhancement initiatives, workflow stabilization, program transitions, coverage planning, and assigned operational support.

• Aid PSP leadership in identifying process inefficiencies, reimbursement patterns, coverage challenges, and opportunities to enhance consistency across programs.

• Assist with onboarding, knowledge transfer, or temporary workflow support when programs need additional experienced Care Navigator resources.

• Provide advanced reimbursement support.

• Utilize comprehensive reimbursement knowledge across various provinces, including public and private payer criteria, provincial coverage guidelines, prior authorization procedures, appeals, special authorization submissions, and escalations with employers or insurers.

• Collaborate with patients, insurers, healthcare professionals, pharmacies, infusion or injection service providers, and internal PSP teams to resolve reimbursement and access challenges.

• Facilitate patient and program support.

• Serve as a contact point for patient-related aspects of the PSP while providing assigned coverage or project support.

• Support timely patient enrollment, telephone assistance, maintenance calls, adherence follow-up, and ongoing case management as required by the designated program.

• Review, assess, and verify patient information for accuracy and completeness to facilitate the initiation and continuation of services.

• Maintain precise and timely patient, clinic, and program data within the Customer Relationship Management (CRM) system.

⛳️ Requirements

• A post-secondary education in healthcare, life sciences, business administration, or a related discipline is preferred.

• A minimum of 3–5 years of direct experience in immunology Patient Support Programs is required.

• Proven experience in supporting reimbursement processes across multiple Canadian provinces is necessary.

• Bilingual proficiency in English and French is an asset.

• Extensive experience in reimbursement is required, including coordination with private insurance, provincial public coverage, special authorization processes, appeals, payer follow-up, and patient financial assistance pathways.

• Advanced understanding of public and private reimbursement frameworks, payer systems, documentation prerequisites, and province-specific reimbursement protocols is mandatory.

• Ability to swiftly learn and apply program-specific requirements while providing short-term coverage, project assistance, and operational continuity across different PSPs.

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

🏝️ Benefits

• Competitive salary along with a generous vacation entitlement.

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

• Paid sick days.

• Comprehensive benefits package including dental and extended health benefits, accidental death & dismemberment (AD&D), long-term disability (LTD), and employee/dependent life insurance.

• Employee and Family Assistance Program.

• RRSP matching program.