Jobs
>
Toronto

    Nurse Practitioner Case Managers: - Toronto, ON, Canada - Bayshore HealthCare

    Bayshore HealthCare
    Bayshore HealthCare Toronto, ON, Canada

    1 week ago

    Bayshore HealthCare background
    Description
    This position will be a single point of contact offering case management support services to plan members.

    Act as a resource to Pharmacies, and Patient Support Programs and continuous support for plan members for on‐going support with coverage, access to medications, and reimbursement navigation.

    This position reports into the Program Manager, Payor Solutions.
    Pay rate - $57,000 to $60,000

    DUTIES AND RESPONSIBILITIES
    Liaise and advocate with insurance companies, Patient Support Programs, physician' offices and healthcare professionals to maximize reimbursement solutions
    Encourage plan member enrollment in the applicable Patient Support Program
    Completes and/or reviews Prior Authorization forms prior to submission to insurers, when the plan member is not enrolled within a Patient Support Program
    Maintain in depth knowledge of public, private, and federal funding mechanisms nationally for all program drugs.
    Maintain detailed electronic notes in the plan members file

    Gather all pertinent and appropriate coverage information from the plan member or Patient Support Program to complete pharmacy referrals (Private and/or Public insurance, or financial assistance) in a concise, organized, and professional manner.

    Proactively offer counseling, advocacy, and assistance for plan members.

    Act as a central resource liaison for program stakeholders, which include private and public insurers, pharmacies, nurses, and Patient Support Programs.

    Adjudicate prescriptions to external payers and support Bayshore Pharmacies with troubleshooting any adjudication error or reimbursement issues identified.
    Communicates with plan members' third-party plans to troubleshoot rejected claims.
    Coordinate specialty pharmacy services once funding has been secured
    Provide updates to stakeholders as requested.
    Potential for large amount of telephone support required.
    Participate in ongoing internal and/or external continuing education activities.
    Adhere to Bayshore Policies and Procedures.

    Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System as well as specific performance indicators for the project.

    Participate in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns.
    Maintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel.
    Complete other tasks as requested.
    Job Qualification
    .Education and/ or Experience
    Secondary School Diploma.
    Minimum of 2 years' experience in customer service, in an office or pharmacy setting
    Experience in the insurance, healthcare, pharmaceutical and Private/Public payers within Canada
    Strong computer and technical skills: Excel, Word, Outlook
    Experience in specialty pharmacy workflow with Kroll and NAV software
    Professional / courteous / efficient telephone manner
    Proven ability to organize time, set priorities and multi-task to meet various competing work deadlines
    Candidate must have strong communication and interpersonal skills
    Ability to work independently and in a team environment
    Attention to detail
    Excellent written and verbal communication skills
    Comfort with investigating and making decisions using sound judgment
    Familiarity with PIPEDA and how it applies in a confidential plan member environment.
    Bilingualism, French/English is an asset.
    "At Bayshore Healthcare, our commitment to Equity, Diversity & Inclusion is our strength. This is how we bring our vision of being the difference in the lives of those we care for, work with and in our communities. We have a great sense of pride in creating a culture of belonging, where individual differences are embraced and celebrated, through programs, resources and policies that support each individuals purpose, potential and wellbeing."
    Bayshore operates in accordance with the Accessibility for Ontarians with Disabilities Act, and applicable Provincial Human Rights Codes.
  • Sun Life

    Disability Case Manager

    2 weeks ago

    Sun Life Toronto, Canada Temps plein

    Description · de poste: Are you passionate and actively looking to contribute to the health of Canadians? Do you want to be part of our journey in developing the next greatest digital experience? As a leading provider of health benefits in Canada, Sun Life supports the health ca ...

  • Alight

    Bilingual Disability Case Manager

    2 weeks ago

    Alight Ontario, Canada Regular

    Our story · At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight." · Our Values: · Champion People – be empathetic and help create a p ...

  • Alight Solutions

    Bilingual Disability Case Manager

    3 weeks ago

    Alight Solutions Ontario, Canada

    Our story · At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight." · Our Values: · Champion People – be empathetic and help create a pl ...

  • University of Toronto

    Case Manager

    2 weeks ago

    University of Toronto Toronto, Canada

    **Date Posted**:08/09/2023 · **Req ID**: 33362 · **Faculty/Division**: VP & Provost · **Department**: Sexual Violence/High Risk · **Campus**: St. George (Downtown Toronto) · **Description**: · **Position Summary**: · The Office of Safety and High Risk at the University of Toronto ...

  • Legal Aid Ontario

    Case Manager

    2 weeks ago

    Legal Aid Ontario Toronto, Canada

    Union: The Society · - Job Number: J · - Job Title: Case Manager · - Job Type: Permanent Full Time · - City, Province, Country: Toronto, Ontario, Canada · - Job Location: Toronto · - Job Category: Legal · - Job Classification: SL · - Role Designation:- Open Positions: 1 · - Post ...

  • Reconnect Community Health Services

    Case Manager

    3 weeks ago

    Reconnect Community Health Services Toronto, Canada

    **Positions Available**: _1_ · **Compensation**:_$51,141.35 to $63,570.56_ · **Unionized Position**:_Yes_ · **Hours of Work**:_37.50 hours per week_ · **Union**:_OPSEU L5116_ · **Position Type**:_Full-time Permanent_ · **Job Class**: _Clinical_ · Reporting to a program manager, t ...

  • Reconnect Community Health Services

    Case Manager

    3 weeks ago

    Reconnect Community Health Services Toronto, Canada

    **Positions Available**: 1 · **Position Type**: Full-Time Permanent · **Hours of Work**: 37.5 hours per week · **Unionized Position**:Yes, OPSEU L5116 · **Annual Rate**:$51, $63,570.56 · **Benefits**:Full time positions are eligible for vacation, paid-sick days, as well as health ...

  • Legal Aid Ontario

    Case Manager

    2 weeks ago

    Legal Aid Ontario Toronto, Canada

    Company Bio · Legal Aid Ontario employees are committed to making a difference in the lives of our clients. · As an integral partner in the Justice system, working at Legal Aid Ontario is more than just a job. It's an opportunity to help people who need it the most; to ensure eac ...

  • Parkdale Queen West Community Health Centre

    Case Manager

    3 weeks ago

    Parkdale Queen West Community Health Centre Toronto, Canada

    **INTERNAL/EXTERNAL POSTING** · **Full-Time Contract Position** · **Queen West Site** · **Case Manager - Safer Opioid Supply (SOS)** · **1.0 FTE Full-Time Mat-Leave Contract Position (35 hours/week),** · **Bargaining Unit - UFCW Local 175** · **Parkdale Queen West Community Healt ...

  • COTA Health

    Case Manager

    1 week ago

    COTA Health Toronto, Canada

    **CASE MANAGER** · **Mobile** **Crisis Intervention Team - Case Management Program (MCIT-CMP)** · **(2) Two Bargaining Unit, Permanent **Full-Time** · **About Cota** · If you're looking to contribute your expertise at a community-based organization making a positive impact in the ...

  • COTA Health

    Case Manager

    3 weeks ago

    COTA Health Toronto, Canada

    **CASE** **MANAGER** · **Mobile** **Crisis Intervention Team-Case Management Program (MCIT-CMP)** · **(2) Two Bargaining Unit, Permanent **Full-Time Positions** · **Monday-Friday 9:00am-5:00pm** · **About Cota** · If you're looking to contribute your expertise at a community-base ...

  • Reconnect Community Health Services

    Case Manager

    2 weeks ago

    Reconnect Community Health Services Toronto, Canada

    **Case Manager - Crisis Outreach Services for Seniors** · **Positions Available**: 1 · **Position Type**: Full-Time Permanent · **Hours of Work**: 37.5 hours per week · **Annual Rate**:$51,141.35 to $63,570.56 per annum · **Benefits**:Full time positions are eligible for vacation ...

  • YMCA of Greater Toronto

    Case Manager

    2 weeks ago

    YMCA of Greater Toronto Toronto, Canada

    Salary Rate: $45,500 - Check out the YMCA's total compensation package · Location: Wagner Green YMCA · Work Hours: 37.5 hours per week · Employment Type: Full Time Salaried Contract · Number of Vacancies: 1 · Anticipated Start Date: December 1, 2023 · Deadline to Apply: November ...

  • John Howard Society Ontario

    Case Manager

    3 weeks ago

    John Howard Society Ontario Toronto, Canada

    **Case Manager**: Location: | Posted on: August 1, 2023 · **Location**:John Howard Society of Toronto** · **Job Type**: Full Time · **Application Deadline**: August 11, 2023 at 11:59pm · The Case Manager provides direct service to chronically homeless men with complex needs inclu ...

  • Na-Me-Res (Native Men's Residence)

    Case Manager

    2 weeks ago

    Na-Me-Res (Native Men's Residence) Toronto, Canada

    As a member of the Mino Kaanjigoowin team, the Case Manager provides physical, emotional, mental and spiritual care and support for clients with mental illness, concurrent disorders and special needs in order to assist them to transition from homelessness to stable and secure lon ...

  • Jean Tweed Treatment Centre

    Case Manager

    3 weeks ago

    Jean Tweed Treatment Centre Toronto, Canada

    **Case Manager - Bathurst Housing, FT** · **Full-Time, Permanent (1)** · - **Classification: Case Manager**_ · - **Job Title: Case Manager, Bathurst Housing**_ · - **Location: Toronto, Ontario**_ · - **Hours of Work: 37.5 hours per week, Monday to Friday, 8:00am - 4:00pm**_ · - * ...

  • Parkdale Queen West Community Health Centre

    Case Manager

    3 weeks ago

    Parkdale Queen West Community Health Centre Toronto, Canada

    **JOB POSTING** · **Full Time Regular Positions** · **1 at the Queen West Site, 1 at the Parkdale Site** · **Job ID: · **Case Managers - Consumption Treatment Services (CTS)** · **Two (2) Full-Time Regular Positions (35 hours/week), Bargaining Unit - UFCW Local 175** · **Parkdal ...

  • PlanIT Search

    Case Manager

    2 weeks ago

    PlanIT Search Toronto, Canada

    **Job Overview** · The Case Manager will be the point of contact for members requiring both medical and non-medical assistance. You will help members find health care providers, book appointments, and make travel arrangements. You will be responsible for communicating the availab ...

  • Reconnect Community Health Services

    Case Manager

    2 weeks ago

    Reconnect Community Health Services Toronto, Canada

    **Positions Available**: 1 · **Position Type**: Full-Time Permanent · **Hours of Work**: 37.5 hours per week · **Annual Rate**: $51, $63,570.56 per annum · **Benefits**:Full time positions are eligible for vacation, paid-sick days, as well as health and RRSP benefits. · Reconnect ...

  • LOFT Community Services

    Case Manager

    2 weeks ago

    LOFT Community Services Toronto, Canada

    **DATE**:April 19th, 2024 · **LOCATION**:Toronto, ON - IPCT** -** Baycrest Inter-professional Primary Care Team **COMPENSATION**:$53,630- $65,589 Annually Prorated · LOFT Community Services is a unique and dynamic charitable organization that supports people living with complicat ...