Senior Care Navigator

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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

• Cross-Program Coverage and Continuity • Provide vacation, sick leave, and temporary coverage for Care Navigators across multiple PSPs. • Ensure continuity of patient care during coverage periods, including timely follow-up, documentation, reimbursement activity, and adherence to program-specific KPIs. • Quickly learn and apply different program workflows, escalation pathways, client expectations, and reporting requirements. • Special Projects and Operational Support • Provide dedicated support for special projects across the PSP, including process improvement initiatives, workflow stabilization, program transitions, coverage planning, and operational support as assigned. • Support PSP leadership by identifying process gaps, reimbursement trends, coverage barriers, and opportunities to improve consistency across programs. • Assist with onboarding, knowledge transfer, or temporary workflow support when programs require additional experienced Care Navigator capacity. • Advanced Reimbursement Support • Apply extensive reimbursement expertise across multiple provinces, including public and private payer requirements, provincial coverage criteria, prior authorization processes, appeals, special authorization submissions, and employer or insurer escalations. • Collaborate with patients, insurers, physicians, pharmacies, infusion or injection service providers, and internal PSP teams to resolve reimbursement and access barriers. • Serve as a knowledgeable resource for complex reimbursement scenarios by supporting Care Navigators and PSP leadership with payer-specific requirements and escalation recommendations. • Patient and Program Support • Act as a point of contact for patient-related elements of the PSP when providing assigned coverage or project support. • Support timely patient enrollment, telephone support, maintenance calls, adherence follow-up, and ongoing case management as required by the assigned program. • Review, analyze, and validate patient information for accuracy and completeness to support initiation and continuation of services. • Maintain accurate and timely patient, clinic, and program information within the Customer Relationship Management (CRM) system. • Maintain confidentiality of patient, client, and corporate information and discuss information only with appropriate personnel. • Complete additional duties as requested by the Manager.

🎯 Requirements

• Post-secondary education in healthcare, life sciences, business administration, or a related field is preferred. • Minimum 3–5 years of direct immunology Patient Support Program experience is required. • Demonstrated experience supporting reimbursement across multiple Canadian provinces is required. • Bilingualism (English and French) is an asset. • Extensive reimbursement experience is required, including private insurance coordination, provincial public coverage, special authorization processes, appeals, payer follow-up, and patient financial assistance pathways. • Advanced knowledge of public and private reimbursement structures, payer systems, documentation requirements, and province-specific reimbursement processes is required. • Ability to rapidly learn and apply program-specific requirements while providing short-term coverage, project support, and operational continuity across different PSPs. • Must be able to work from home and have a quiet, private home office space. • Excellent verbal and written communication skills. • 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.

🏖️ 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