Bilingual Case Manager (Remote)

Sentrex Health Solutions Inc.; Canada; Remote; CAD 60,000 - 80,000; Full time

Benefits offered by this job

Competitive salary

Wellness program

Paid sick days

Benefits package

RRSP matching

Employee assistance program

Job summary

Sentrex Health Solutions Inc. is seeking a Bilingual Case Manager to oversee enrollment, reimbursement, and service coordination for patients prescribed therapies.

You will support physicians and patients in navigating private and provincial drug plans to ensure timely access to prescribed treatments. The role requires English and French fluency, strong communication, and experience in patient support programs.

Qualifications

• Bilingualism in English and French is required.
• Strong analytical and communication skills are essential.
• Excellent customer service, problem-solving and conflict-resolution abilities.

Responsibilities

• Manage patient enrollment into the Patient Support Program.
• Coordinate documentation for reimbursement with insurers and physicians.
• Review charts and guide physicians on coverage for public/private plans.
• Provide program education and manage patient and physician expectations.
• Ensure timely access to therapy and maintain KPI-driven service levels.
• Update CRM with patient and clinic information and collaborate with internal teams.

Skills

Bilingual English/French

Analytical skills

Customer service

Problem solving

Interpersonal skills

Communication

Typing

Tools

CRM software

Job description

Work Hours: Flexibility to work within the operating hours of Monday - Friday, between 8:00am - 8:00pm (EST)

Work Hours: Flexibility to work within the operating hours of Monday - Friday, between 8:00am - 8:00pm (EST)

Work Hours: Flexibility to work within the operating hours of Monday - Friday, between 8:00am - 8:00pm (EST)

The Opportunity: The Bilingual 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 Bilingual 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.

The Opportunity:

The Bilingual 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 Bilingual 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.

A Day in the Life (What you will do here):

• 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 requested by the Manager.

What you need to ensure you are set up for success:

• 2-3 years of experience in Patient Support Program
• Bilingualism (English and French) is required
• 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
• Experience in oncology, rare disease considered an asset
• Advanced knowledge of the pharmaceutical distribution industry
• Must be able to work from home and have a quiet, private home office space
• Strong analytical skills including interpretation of regulation and legislation
• Excellent customer service, problem-solving, and conflict resolution skills
• Effective interpersonal skills
• Typing skills and ability to be a strong functional user of various computer-based programs

What makes you a great fit for this team:

• Your commitment to providing a high level of service to your internal and external clients.
• You are highly adaptable with a track record of success during times of growth and organizational change.
• You have a proven track record of developing trust and influence at multiple levels.
• You demonstrate an impactful and candid communication style.
• You have exceptional organizational skills with the ability to build effective working relationships with colleagues, management, and stakeholders.

We value our employees! Our permanent full-time employees are provided with a:

• 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

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.

Accommodations can be made available upon request for those candidates taking part in the selection process.

Sentrex hiring managers may use artificial intelligence tools to assist them in the recruitment process.