Spécialiste du soutien aux patients

Lieu: 1685 Tech Ave, Mississauga, Ontario, L4W 0A7 Chez Shoppers Drug Mart/Pharmaprix, nous innovons en matière de santé et de bien-être au Canada. Des ordonnances aux cliniques sans rendez‑vous, en passant par un programme de fidélisation des plus appréciés, nous prenons soin de nos clients et les soutenons grâce à des nouvelles approches tous les jours. Avec plus de 1300 magasins détenus et exploités localement d’un océan à l’autre, le réseau de Shoppers Drug Mart/Pharmaprix est un milieu de travail et de magasinage formidable. Nous sommes déterminés à bâtir une équipe talentueuse prônant la collaboration, la générosité et l'inclusion. Joignez‑vous à notre équipe et contribuez à créer un avenir sain pour votre carrière et pour tous les Canadiens. Pourquoi ce role est-il important? Position Summary The Patient Support Specialist is a senior individual contributor role within SHN's Central Program Operations team. This role serves as the primary point of contact for patients, caregivers, healthcare providers (HCPs), clinics, pharmacies, and enterprise partners across a portfolio of up to 70 Patient Support Programs. Operating across all inbound omnichannel touchpoints — phone, email, and patient portal — the Patient Support Specialist manages complex reimbursement queries, program escalations, and patient access inquiries for both in‑network and out‑of‑network interactions. This is a high‑accountability role that requires deep knowledge of the Canadian payer landscape, PSP operations, and patient‑centred service delivery. This role supports one of the most complex PSP environments in Canada — 70 programs, 150,000+ patients, and a diverse stakeholder base spanning patients, caregivers, HCPs, pharmacies, clinics, and enterprise partners. The successful candidate brings both the technical expertise and the interpersonal depth to navigate that complexity with consistency and care. Core Responsibilities Inbound Patient and Stakeholder Support
- Serve as the first point of contact for inbound inquiries via phone, email, and patient portal across all assigned PSPs
- Provide accurate, timely, and empathetic support to patients, caregivers, HCPs, pharmacies, clinics, and enterprise partners
- Navigate complex multi-program environments, applying the correct program protocols and eligibility criteria for each interaction
- Manage high-volume inbound queues while maintaining service level standards and quality expectations
- Triage and prioritize interactions based on urgency, clinical sensitivity, and program‑specific requirements Reimbursement Support — In‑Network and Out‑of‑Network
- Manage inbound reimbursement queries from patients, HCPs, pharmacies,
- Provide accurate guidance on coverage determinations, prior authorization (PA) status, co‑pay and patient assistance program eligibility, and claims adjudication
- Liaise with payers, insurers, and benefit managers to resolve complex reimbursement issues on behalf of patients and providers
- Support patients navigating out‑of‑network access pathways including exceptional access, special authorization, and compassionate use programs
- Document all reimbursement interactions accurately and completely in the case management system
- Identify reimbursement trends and escalate systemic issues to the supervisor with supporting case data Escalation Management
- Receive, triage, and manage escalated inquiries from patients, clinics, physicians, pharmacies, and enterprise partners
- Apply sound judgment in determining escalation pathways — clinical, reimbursement, operational, or compliance — and route accordingly
- Own escalated cases from intake to resolution, maintaining proactive communication with all parties throughout
- Recognize and elevate potential adverse event disclosures immediately per program pharmacovigilance protocols
- Document escalation rationale, actions taken, and resolution outcomes in the case management system Omnichannel Case Management
- Manage interactions seamlessly across phone, email, and patient portal, maintaining consistent case continuity regardless of channel
- Ensure all patient and stakeholder interactions are documented in the CRM with accuracy, completeness, and timeliness
- Review prior interaction history before engaging with a returning patient or stakeholder to provide a connected, informed experience
- Identify and flag gaps in omnichannel continuity to the supervisor for process improvement Program Knowledge and Compliance
- Maintain deep working knowledge of all assigned PSP program protocols, eligibility criteria, and service delivery standards
- Stay current on changes to program design, payer policies, and regulatory requirements affecting PSP operations1
- Adhere to all privacy, consent, and documentation obligations under PIPEDA, PHIPA, and program‑specific requirements
- Recognize and report potential adverse events, privacy incidents, and compliance concerns immediately per establishe