Field Case Manager
Recruiting.com
full-time
Posted on:
Location Type: Hybrid
Location: Edmonton • Canada
Visit company websiteExplore more
About the role
- Customize program elements to meet the needs of assigned prescribing physicians
- Review patient status and assist the prescribing physician to complete patient enrolment
- Prepare payer forms to access public or private coverage
- Identify obstacles to obtaining coverage
- Develop strong working relationships with physicians and physician office staff
- Proactively provide assistance to resolve issues regarding assigned physicians
- Provide training to physicians and clinics on the program and new initiatives
- Act as a liaison and provide ongoing feedback to the Program Manager
- Complete all relevant reports as per specified timelines
- Welcome each patient to the program and capture required patient information
- Provide reimbursement payer guidelines to patients and physicians
- Coordinate private and public coverage activity between patient, physician, and insurers
- Confirm outcome of reimbursement navigation with the patient
- Report Adverse Events / Severe Adverse Events following program Standard Operating Procedures
Requirements
- A Bachelor’s degree in health care or a related discipline
- Requires a minimum five (5) years, in the healthcare, pharmaceutical or insurance industry or related experience
- Case management experience preferred
- Available to travel within an assigned territory, some overnight travel may be required
- Valid Driver’s License, current auto insurance policy and access to reliable transportation
- Experience and background in various therapeutic areas is an asset
- Background in business administration (pharmaceutical) sales and marketing an asset
- Knowledge of private and public reimbursement structure, systems, and processes
- Experience with reimbursement navigation, special authorization, appeals process, and conducting field-based reimbursement support and consultation
- Strong analytical skills including interpretation of regulation and legislation
- Fluency in French and/or English may be required depending on program and geographic location
Benefits
- medical, dental, and vision care
- backup dependent care
- adoption assistance
- infertility coverage
- family building support
- behavioral health solutions
- paid parental leave
- paid caregiver leave
- variety of training programs
- professional development resources
- opportunities to participate in mentorship programs
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
case managementreimbursement navigationspecial authorizationappeals processanalytical skillsinterpretation of regulationinterpretation of legislation
Soft Skills
relationship buildingproblem solvingcommunicationtrainingliaison
Certifications
Bachelor’s degree in health carevalid Driver’s License