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Senior Bilingual Case Manager – 18 month contract
Sentrex Health Solutions. Responsible for the timely enrollment of the patient into the Patient Support Program.
About the role
Key responsibilities & impact- 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
What you’ll need- A Bachelor’s Degree or College Diploma in a relevant field of study.
- Bilingualism (English and French) will be required
- 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
- Proficiency in Adobe Acrobat, SharePoint, and Microsoft Office applications is required.
- Strong ability to consistently meet deadlines and prioritize projects.
- Exceptional organizational skills and ability to activities both for self and others effectively.
- Ability to establish and build healthy working relationships and partnerships with peers.
- Ability to work independently, make decisions, multitask, and solve problems under a high degree of pressure.
- Flexible, resourceful, creative, and proactive work style with an enthusiastic attitude.
- Results-oriented with an ability to handle multiple tasks and maintain a high level of performance.
- Advanced ability to learn and understand new systems and software quickly.
- Excellent problem-solving skills: ability to resolve issues effectively and efficiently.
Benefits
Comp & perks- 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
ATS Keywords
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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 reportingContinuous learning
Soft Skills
Excellent verbal communicationExcellent written communicationCustomer serviceProblem-solvingConflict resolutionInterpersonal skillsOrganizational skillsAbility to multitaskDecision-makingTeamwork