Case Manager (Western Canada) - Remote

Sentrex Health Solutions Inc.; Canada; Remote; CAD 50,000 - 80,000; Full time

Job summary

Join a forward-thinking company that is a leader in patient support solutions within the pharmaceutical industry. As a Case Manager, you will play a crucial role in managing patient enrollment and reimbursement processes, ensuring timely access to essential treatments. This position offers a collaborative and engaging workplace culture, promoting a healthy work-life balance and opportunities for growth. With a commitment to diversity and inclusion, this innovative firm values your unique talents and contributions, making it an ideal place to advance your career while positively impacting patient outcomes.

Benefits

Competitive Salary

Generous vacation entitlement

Wellness Program

Paid Sick Days

Dental & Extended Health Benefits

Employee & Family Assistance Program

RRSP Matching Program

Qualifications

• Experience with reimbursement billing and special access processes.
• Strong analytical skills and knowledge of pharmaceutical distribution.

Responsibilities

• Manage enrollment and reimbursement processes for patients.
• Collaborate with patients, insurers, and physicians for documentation.
• Ensure timely access to prescribed treatments for patients.

Skills

Bilingualism (English and French)

Reimbursement billing

Analytical skills

Customer service

Conflict resolution

Interpersonal skills

Education

Bachelor's degree in a relevant field

Tools

Customer Relationship Management (CRM) tools

Job description

Virtual BC
Virtual British Columbia
3-250 Shields Court
Markham, ON L3R9W7, CAN

Virtual BC
Virtual British Columbia
3-250 Shields Court
Markham, ON L3R9W7, CAN

Virtual AB
Virtual Alberta
3-250 Shields Court
Markham, ON L3R9W7, CAN

Virtual AB
Virtual Alberta
3-250 Shields Court
Markham, ON L3R9W7, CAN

Work Hours: Monday to Friday 9am-5pm (Pacific Time)

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:

• We are 100% Canadian with locations across the country
• State-of-the-art facilities to provide high-quality products and services
• The opportunity to be a part of a winning, high-performing team
• Collaborative, engaging workplace culture – we are passionate about our people!
• Flexible working environment that promotes a healthy work-life balance
• Diverse and inclusive culture where your talent and commitment to excellence is welcomed and valued
• High-growth environment that provides opportunities for learning and growth supported by our Employee Development Program and industry-leading, in-house corporate training offered throughout the year

The Opportunity:

The Case Manager is responsible for managing all the aspects of the enrollment, reimbursement process, and service coordination for patients who have 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.

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 the 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 initiate 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 the 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 (timesheets, 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:

• Bilingualism (English and French) 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
• 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.

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