Resource Utilization Group Auditor III – Skilled Nursing Facility, SNF
EXL
Field Case Manager
Recruiting.com
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇨🇦 Canada
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Single point of contact for the program with physicians
- Educate physicians and/or their staff on various program services
- Provide therapy guidelines to manage physician expectations with respect to reimbursement
- Consult patient charts in order to effectively complete necessary paperwork to obtain coverage
- Assist MDs in completing Special Authorization (SA) forms, enrolment forms, prescription renewals, and other documentation
- Provide ongoing updates to physicians on their patients
- Customize current program elements to meet the needs of assigned physicians: adjust based on in-clinic and remote MD needs
- Identify areas for risk and foster proactive, continued quality improvement
- Work collaboratively with other team members in various roles to coordinate the patient journey
- Participate in scheduled physician meetings with sales representatives
- Attend Continuous Medical Education events and report new activities
- Regular travel to various physician offices
- Adverse Event reporting
- Mentoring new FCMs
- Assist when needed with the development of special initiatives
- Assist & support the DM during teleconferences (sharing best practices, tips/tricks, topics to be assigned by DM)
- Be a change management champion
- Attend conferences’ as an AbbVie Care representative or HCP and share the knowledge obtained with the team
- Act as a lead on obtaining feedback from the team & finding solutions
- Lead senior meetings; Send surveys to their respective roles and meet/discuss with DM afterwards
- Act as a resource for the team - Be a leader & role model
- Proactively identify issues and offer solutions / efficiencies to share with the DM
- Adhoc duties as assigned #LI-SH1
Requirements
- Registered nurse (RN), Licensed Practical Nurse (LPN) or Bachelor’s degree
- Related degree may be considered (pharmacists, science degrees) or equivalent transferable skills
- Experience in public or private third party reimbursement arena or pharmaceutical sales experience, managed care, or clinical support, or related experience an asset
- Bilingualism is an asset (requirement for province of Quebec)
- Previous Case Manager experience an asset
- Basic CCPE an asset
- Exceptional customer service and interpersonal skills
- Ability to manage multiple tasks and priorities at once
- Comprehension of medical terminology
- Strong analytical and organizational skills
- Ability to analyze current enrollment volume by MD
- Ability to engage with a physician and his/her staff as a trusted and well-informed medical counterpart
- Excellent time management skills & sense of urgency
- Ability to collaborate effectively with program associates
- Ability to work autonomously in a remote setting
- Ability to communicate effectively both orally and in writing and in both English and French (oral and written) for the Quebec and New Brunswick Provinces.
- Detail and result oriented
- Ability to adapt to change and ambiguity
- Strong computer skills and knowledge of Microsoft Office
- Ability to attend Continuous Healthcare Education (CHE) events with HCPs, which may occur outside regular business hours
- Hold and maintain a valid, non-expired, unrestricted driver’s license and possess a car
- Must have a private, dedicated home office space that accommodates equipment supplied by Innomar Strategies
Benefits
- We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day.
- medical, dental, and vision care
- comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness
- support for working families (backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave)
- training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
Registered Nurse (RN)Licensed Practical Nurse (LPN)Bachelor's degreeCase Manager experienceBasic CCPEMedical terminology comprehensionAnalytical skillsCustomer service skillsReimbursement knowledgePharmaceutical sales experience
Soft skills
Interpersonal skillsTime management skillsOrganizational skillsAbility to manage multiple tasksCollaboration skillsCommunication skillsDetail-orientedAdaptability to changeProblem-solving skillsMentoring skills
Certifications
Valid driver's license
