Case Manager- Ontario

Join to apply for the Case Manager- Ontario (Remote) role at Sentrex Health SolutionsPosition Type: Full-Time, PermanentDepartment: Patient ProgramsWork Location: OntarioWork Arrangement: RemoteWork Hours: Monday to Friday, 9 am to 5 pmTravel Required: Up to 30% as requested (Ontario)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.The OpportunityThe Case Manager is responsible for managing all 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 LifeResponsible 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 successA Bachelor’s degreeBilingualism (English and French) is an assetExperience with reimbursement billing, special access, the appeals process, and conducting field-based reimbursement support and consultation is an assetKnowledge of private and public reimbursement structure, systems, and the process is an assetMust be able to work from home and have a quiet, private home office spaceExcellent verbal and written communication skills in English.Strong analytical skills including interpretation of regulation and legislationAdvanced knowledge of the pharmaceutical distribution industryExcellent customer service, problem-solving, and conflict resolution skillsEffective interpersonal skillsTyping skills and ability to be a strong functional user of various computer-based programsMust have valid G license for travel within OntarioWhy join Sentrex?We value our employees Our permanent full-time employees are provided with a competitive salary and generous vacation entitlement, Wellness Program, Paid Sick Days, Competitive Benefits Package, Employee & Family Assistance Program, and 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. #J-18808-Ljbffr