Position Type: Full-Time
Department: Patient Programs
Work Location: Canada
Work Arrangement: Remote (East Coast)
Work Hours: Standard Business Hours Monday to Friday 9am-5pm
Travel Required: No
A proudly Canadian company, Sentrex Health Solutions is a fully integrated specialty distributor and patient support provider for pharmaceutical manufacturers, physicians, and their patients. We provide innovative solutions focused on ensuring patients have access and the support they need to maximize their treatment outcomes. We do this through strategic distribution models and patient support programs that are backed by powerful, integrated technology, a dedicated in-house creative agency, and experienced, cross-functional teams. Our core capabilities include Specialty Pharmacy Services, Customized Solutions for Warehouse, Wholesale & Distribution, Patient Support Programs, Strategic Creative Services as well as HCP & Clinic Services.
Come and join our team! But first, let us tell you why we love working here:
The Case Manager is responsible for managing all the aspects of the enrollment, reimbursement process, and service coordination for patients who has been prescribed the drug by physicians. The Case Manager will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, and provide continuous support for patients through excellent communication skills and available resources to ensure patients have easy access to their prescribed therapy.
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 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.
Identifies obstacles to obtaining coverage and channels this information to the Program Manager and/or Assistant Program Manager.
Completes all relevant reports (time sheets, expenses, mileage, validate CRM reports, etc.) as per specified timelines and as per required standards.
Additional duties as determined by your Manager
What you need to ensure you are set up for success:
Post secondary education with minimum of 2 years experience in health care
1-2 years of experience in Patient Support Program is an asset
Experience with reimbursement billing, special access, the appeals process, and conducting field-based reimbursement support and consultation is an asset
Knowledge of private and public reimbursement structure, systems, and the process is an asset
Must be able to work from home and have a quiet, private home office space
Excellent verbal and written communication skills in English
Strong analytical skills including interpretation of regulation and legislation
Advanced knowledge of the pharmaceutical distribution industry
Excellent customer service, problem-solving, and conflict resolution skills
Typing skills and ability to be a strong functional user of various computer-based programs
We value our employees! Our permanent full-time employees are provided with a:
Sentrex Health Solutions is proud to be an equal opportunity employer demonstrated by our commitment to diversity, inclusion, belonging, equity, and accessibility. We provide a safe space for all team members to express their individuality within our corporate culture.
We encourage you to apply and accept all applications. We realize that not every candidate will meet every single desired qualification. If your experience looks a little different from what we have identified and you think you can bring value to the role, we would love to learn more about you!
Accommodations can be made available upon request for those candidates taking part in the selection process
Originally posted on Himalayas
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