Ppn Care Coordinator

1 month ago

Mississauga, Canada Greenshield Holdings Full time

**About Greenshield**

Green Shield is the first integrated health services organization in Canada that is both a payer (offering insurance, administering benefits, and paying claims) and a provider (offering medical, mental health, and pharmacy services).

This evolution also deepens our social mission through both financial support and the direct delivery of services to support local communities and underserved populations across Canada.

As a part of Greenshield group of companies, Greenshield Administration provides innovative health benefit solutions for the small-mid size companies in Canada. Recognized as the leading alternative to the traditional insurance companies, in a market where small and mid-sized employers have been largely underserved Greenshield Administration sets itself apart from the competition, by using technology, creative product development and a stellar customer experience to solve problems for employers. Honeybee Benefits is our next generation benefits platform built for today’s modern workforce that empowers employers to compete better for talent.

A Specialty Care Program Care Coordinator (CC) provides support, education and health care services to private payor’s plan members and their dependents who have a.

As the primary point of contact for patients and their circle of care, you will provide Specialty Care Program services such as plan member navigation into network pharmacies, troubleshooting network pharmacy inquiries, managing exception requests, assessing patient adherence based on validated questionnaires, patient education and health coaching. This position reports into the PSP/PPN Lead.

**Responsibilities**:

- Telephone support: Provide Patients with telephone support services that enable CC’s to respond to questions relating to patients, program, network pharmacies and Patient Support Programs (PSPs) that relate to the Specialty Care Program details, network pharmacy issues with PSP copay assistance, patient inquires and questions. Calls include identifying issues, troubleshooting various solutions, and providing SME level information.
- Coordination of Specialty Drug Care Program services: Navigate and coordinate with in-network pharmacies for the dispensing of prescribed drugs that have been included in the PPN patients, including coordination with the patient’s HCPs and PSP.
- Adherence Support services: Complete an initial assessment with patients, to investigate if they are taking their medication as prescribed. Refer any pts that are assessed as medium to low adherence to the Nurse Case Manager for follow up.
- Program materials: Coordinate the distribution of program related materials (e.g. letters, faxes, etc.) to Patients, HCPs, and PSPs**.**:

- Confidentiality: Maintain the confidentiality of all information that relates to the GS Specialty Drug Care program generally and Patients specifically.
- Ensure compliance with provincial/federal privacy legislation.
- Participate in on going internal and/or external continuing education activities.
- Adhere to NKS’s Polices, Processes and Procedures.
- Participate in quality activities and continuous improvement initiatives.

**Requirements**:

- A university/college degree, preferably in a health-related field
- Possess strong clinical expertise and experience in a range of health conditions
- 2 + years case management experience
- Bilingual an asset
- Proven ability to work effectively as part of an interdisciplinary team, demonstrate competence in performance of case management, providing patient education and documentation.
- Excellent organizational, problem-solving, conflict resolution and critical thinking abilities.
- Excellent interpersonal, listening and communication skills (written and verbal), ability to direct conversations and target specific issues.
- Proficient in using technology including: computers and software programs
- Self-regulation of time management and the ability to multi-task and adhere to deadlines
- Familiarity with PIPEDA and how it applies to confidential patient information

**Why us?**

We offer a robust employee benefits offering including:

- Dental care
- Disability insurance
- Employee assistance program
- Extended health care
- Life insurance
- On-site parking
- Paid time off
- RRSP match
- Vision care
- Wellness program

**Schedule**:
Monday to Friday

**Work Location**: Hybrid

**Our Commitment To Your Health**:
We pride ourselves on offering flexible and comprehensive benefits for you and your dependents, covering medical, dental, mental health and more. At GreenShield, we understand that life happens. We offer flexible work hours for the times when you need to put your health, family, or well-being first.

Proficiency in English is required for this position. As part of this role, you will be required to communicate with colleagues, clients, or customers who predominantly use English as their primary language. English language skills are essential to ensu

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