Sentrex Health Solutions

Senior Case Manager

Sentrex Health Solutions

full-time

Posted on:

Location Type: Remote

Location: Canada

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Job Level

Senior

About the role

  • Responsible for the timely enrollment of the patient into the Patient Support Program
  • Collaborate with the patient, insurer and physician regarding the documentation necessary for maximal reimbursement coverage, including the investigation of all public and private insurers and supporting employer escalations as required
  • Reviews patient status and assists the prescribing physician to prepare documentation for public or private coverage by reviewing patient charts, assessing previous therapies and tests
  • Provides therapy guidelines/education on the program to manage patient and physician expectations
  • Collects information and conducts patient financial assessment eligibility based on program guidelines
  • Ensures patient services are coordinated and tracked in a timely manner resulting in quick and continued access to therapy
  • Reports Adverse Events / Severe Adverse Events (AE / SAEs) following approved SOPs
  • Maintain service levels in case management, including telephone answer rates, time to initial contact with the patient, Adverse Events reported within twenty-four hours of receipt and any other KPIs established as the Program level
  • Electronically updates the Customer Relationship Management (CRM) tool by providing timely patient and clinic information
  • Fosters and promotes a spirit of teamwork while working with internal patient support teams
  • Acts a liaison and provides ongoing feedback to the Associate Program Manager based-on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance
  • Provides back-up assistance to PSP Supervisors, Associate Program Managers and Programs Managers when required
  • Identifies obstacles to obtaining coverage and channels this information to the Program Manager and/or Associate Program Manager
  • Recommends corrective actions to ensure deliverables are met
  • Collaborates and participates in PSP team and client meetings as necessary
  • Ensures access to therapy has been expedited determined by effective coordination and tracking, according to Program KPIs
  • Completes all relevant reports (time sheets, expenses, mileage, validate CRM reports, etc.) as per specified timelines and as per required standards
  • Responsible for the creation of work-instructions and training documents as required by the program
  • Aids with program pre and post launch-activities
  • Update and revise training content based on ongoing business needs
  • Deliver training content and facilitate learning sessions in person and virtually while using a variety of methods
  • Manage multiple projects with tight deadlines while providing valuable input to enhance and customize processes that exceed operational needs
  • Be a subject matter expert as it relates to the CRM and Case Management for Patient Programs at Sentrex Health Solutions
  • Shadowing of case managers to provide training and support as needed
  • Provide ad-hoc support to multiple programs, teams, and departments
  • Assists with data clean-up as required
  • Provide additional support with other duties or projects as requested by PSP Management

Requirements

  • Bachelor’s Degree or College Diploma in a relevant field of study
  • 2-5 years of experience in Patient Support Programs with advanced knowledge of Case Management and the pharmaceutical distribution industry
  • Demonstrates an aptitude for continuous learning
  • Advanced knowledge of reimbursement billing, special access, the appeals process, and conducting field-based reimbursement support and consultation is required
  • Must be able to work from home and have a quiet, private home office space
  • Excellent verbal and written communication skills in English
  • Knowledge of private and public reimbursement structure, systems, and the process is required
  • Strong analytical skills including interpretation of regulation and legislation
  • Excellent customer service, problem-solving, and conflict resolution skills
  • Strong interpersonal skills
  • Strong functional user of various computer-based programs
  • Bilingualism (English and French) is an asset
  • Proficiency in Adobe Acrobat, SharePoint, and Microsoft Office applications is required
Benefits
  • Competitive Salary and generous vacation entitlement
  • Wellness Program (5 paid days off for your well-being!)
  • Paid Sick Days
  • Competitive Benefits Package including Dental & Extended Health Benefits, AD&D, LTD & Employee/Dependent Life Insurance
  • Employee & Family Assistance Program
  • RRSP Matching Program
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
Case ManagementReimbursement billingPatient financial assessmentData clean-upTraining content developmentProject managementField-based reimbursement supportDocumentation preparationAdverse Events reportingPatient Support Programs
Soft Skills
Communication skillsCustomer serviceProblem-solvingConflict resolutionInterpersonal skillsTeamworkAnalytical skillsContinuous learningTime managementAdaptability