Bilingual Reimbursement Case Manager - Mississauga, Canada - Bayshore HealthCare

Bayshore HealthCare
Bayshore HealthCare
Verified Company
Mississauga, Canada

3 weeks ago

Sophia Lee

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Sophia Lee

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Description

THIS POSITION IS REMOTE FROM ANYWHERE IN CANADA

CANDIDATES MUST BE FLUENTLY BILINGUAL IN BOTH ENLGLISH AND FRENCH

ABOUT THE ROLE:


The Bilingual Non -Nurse Case Manager will be the point of contact offering support to physicians and medical case management services to patients.

Assist the physician with the completion of all program-specific paperwork and follow-up on submissions pertaining to obtaining drug access through various means to ensure patients have access to their prescribed treatments in a timely manner.

Act as a resource to physicians who are prescribing this medication and continuous support for patients via phone for renewals, and coverage changes.


A DAY IN THE LIFE:


  • Complete outbound and inbound calls to patients, HCPs and other key players to support patients through their treatment journey.
  • Gather all pertinent and appropriate information from the prescribing physician to complete any necessary forms for private and/or provincial insurance in a concise, organized and professional manner.
  • Followup/advocate until a decision is received.
  • Proactively offer counseling, advocacy and assistance for patients.
  • Liaise and advocate with thirdparty providers and provincial governments as necessary to determine coverage options.
  • Complete Reimbursement Navigation & complete other tasks as requested
  • Followup/advocate until a decision is received, ideally securing coverage for the patient.
  • Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, the client and clinics.
  • Ensure ongoing compliance of treatment as well as the completion of ongoing symptom support for patients
  • Provide updates to stakeholders as requested.
  • Participate in ongoing internal and/or external continuing education activities
  • Adhere to Bayshore Policies and Procedures
  • Must be able to identify and report AE's to health Canada, Med Info and enter into source system
  • Report and document Adverse Events as per Pharmacovigilance requirements
  • Provide telehealth support and telephone follow up to patients at specific intervals as set out in the program SOP or SOW
  • 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
  • May require to travel on occasions
Job Qualification


WHAT YOU BRING TO THE TEAM

  • Experience with oncology patients considered a strong asset
  • Must have a proven track record with excellent customer services skills internally as well as externally
  • Experience working with Patient Support Programs (Asset)
  • Excellent verbal and written communication skills and interpersonal skills
  • English & French
  • Reimbursement experience
  • Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.
  • Familiarity with the Special Authorization process for both public and private insurance in assigned territory.
  • Strong Computer and Technical skills: Excel, Word, Outlook, tablets, webportals/internet use
  • Making decisions using sound judgment, and meeting deadlines.
  • Accurate data collection and data integrity
  • Ease with working in a paperless environment.
  • Ability to drive for results
  • Proven ability to work in a team environment
  • Ability to resolve conflict in a professional matter
  • Strong sense of organization and attention to detail
  • Selfregulation of time management and the ability to multitask and adhere to deadlines
  • Familiarity with PIPEDA and how it applies in a confidential patient environment.

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