Bilingual Case Manager

🕒 2 days ago

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Sentrex Health Solutions

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2017

💊 Pharmaceuticals

🤝 B2B

Pharmaceuticals • B2B

Sentrex Health Solutions is a Canadian specialty healthcare services company that partners with pharmaceutical companies, clinics, and patients to deliver customized specialty care solutions. They provide specialty pharmacy distribution and 3PL services, patient support programs, and purpose-built technology to streamline complex care and improve patient access and outcomes. Sentrex works B2B with pharmaceutical partners and healthcare providers while offering direct patient support and clinic-focused solutions.

📋 Description

• 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. • Additional duties as requested by the Manager.

🎯 Requirements

• Post secondary education with experience in healthcare is an asset • 1-2 years of experience in Patient Support Program is an asset • 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 • Must be able to work from home and have a quiet, private home office space • Excellent verbal and written communication skills in English and in French • 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

🏖️ 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