Spécialiste de remboursement, maladies rares

* Communication quotidienne et continue avec le gestionnaire de programme ou le gestionnaire de programme adjoint pour les projets nouveaux et existants;* Démontrer une connaissance approfondie des programmes de maladies rares offerts, y compris la physiopathologie de la maladie, le produit, le domaine thérapeutique, le processus de la maladie, et le mécanisme d'action, et comment appliquer les PONspour les maladies rares;* Démontrer une connaissance approfondie des mécanismes de financement public/privé et fédéral ainsi que des organismes de financement des maladies rares (États-Unis et Canada).* Coordonner les cas avec les médecins et les professionnels de la santé afin de préparer des soumissions répondant aux spécifications et aux critères spécifiques établis par les payeurs des secteurs public et privé.* Coordonner et gérer tous les aspects nécessaires à l'obtention d'une couverture des médicaments d'ordonnance pour les patients;* Coordonner les cas avec les compagnies d'assurance, les bureaux de médecins et les professionnels de la santé afin de maximiser les solutions de remboursement;* Parcourir le processus complexe de démarches pour obtenir une couverture pour les médicaments d'ordonnance et le remboursement de ces médicaments coûteux et qui sauvent des vies;* Coordonner les documents, les soumissions et tous les documents connexes aux compagnies d'assurance et aux programmes de financement public/fédéral;* Mettre en œuvre le test de moyens financiers tel que requis dans le but de maximiser la couverture des médicaments d'ordonnance du patient* Coordonner les processus de pharmacie requis lorsque le financement a été obtenu; et* Le/la spécialiste de remboursement sera également affecté(e) à d'autres fonctions et tâches au besoin de temps à autre.* Daily and ongoing communication with Program Manager / Associate Program Manager for new and existing projects;* Demonstrate in depth knowledge of rare disease program offerings, including the pathophysiology of the disease/product, therapeutic area, disease process, and mechanism of action; and how to apply rare disease SOPs;* Exhibit in depth knowledge of public/private and federal funding mechanisms as well as Rare Disease funding bodies (US and Canada).* Coordinate cases with physician and healthcare professionals in order to prepare submission meeting specific specifications/criteria set by public/private payers.* Coordinate and manage all aspects required in order to obtain prescription drug coverage for patients;* Coordinate cases with insurance companies, physician’s offices and healthcare professionals in order to maximize reimbursement solutions;* Navigate through the complex lobbying process to obtain prescription drug coverage and reimbursement for these life-saving and costly medications;* Coordinate documents, submissions and all related paperwork to insurance companies, public/federal funding programs;* Implement Financial Means Test as required in an effort to maximize patient’s prescription drug coverage* Coordinate pharmacy processes required once funding has been obtained;* Responsible to report all Adverse Events to the assigned units/departments;* The Reimbursement Specialist will also be assigned other duties and tasks as required from time to time.Minimum de 3 ans d'expérience dans l'industrie pharmaceutique, l'assurance ou dans des secteurs liés aux soins de santé; Expérience préalable en matière de remboursement et connaissance des remboursements publics, privés et fédéral est requise; Minimum de trois (3) ans d'expérience en service à la clientèle, OU Cinq (5) ans ou plus d'ancienneté à titre de spécialiste de remboursement Sr. Capacité démontrée à organiser son temps, à établir des priorités et à accomplir plusieurs tâches à la fois afin de respecter diverses échéances de travail concurrentielles; Le/la candidat(e) doit posséder de solides compétences en communication et en relations interpersonnelles, y compris la capacité de communiquer avec les patients dans un contexte de soins de santé sur des sujets extrêmement délicats; **Compétences, Connaissances Et Aptitudes Requises:**Solides compétences analytiques et mathématiques Compétences interpersonnelles et de leadership efficaces * Excellentes aptitudes en résolution de problèmes; capacité à résoudre les problèmes de façon efficace et efficiente.**Primary Duties and Responsibilities:*** Minimum of 3 years’ experience in the pharmaceutical, insurance or healthcare-related industries;* Previous experience in reimbursement and Knowledge of public, private and federal reimbursement is required;* Minimum of three (3) years’ experience in a Customer Service setting; OR Five (5) years or more tenure as a Sr. Reimbursement Specialist* Professional / courteous / efficient telephone manner;* Strong proficiency in Microsoft applications (Outlook, Word, Excel);* Proven ability to organize time, set priorities and multi-task in order to meet various competing work deadlines;* Candidate must have strong communication and interpersonal skills, including the ability to communicate with patients in a healthcare setting on extremely sensitive topics;* Ability to work independently and in a team environment;* Attention to detail; and* Bilingualism, French/English is required.**Experience and Educational Requirements:*** Advanced knowledge of pharmaceutical, or insurance industry* Strong business and financial acumen* Strong analytical and mathematical skills* Ability to communicate effectively both orally and in writing* Effective interpersonal and leadership skills* Effective organizational skills; attention to detail* Ability to consistently meet deadlines* Excellent problem-solving skills; ability to resolve issues effectively and efficientlyThe successful candidate may have daily contacts with unilingual English-speaking customers, patients or peers from cross-functional teams.Cencora is a leading global pharmaceutical solutions company that is committed to improving the lives of people and animals everywhere. We connect manufacturers, providers, and patients to ensure that anyone can get the therapies they need, where and when they need them.We’re a purpose-driven organization, where all of our team members around the world are united in our responsibility to create healthier futures. We work together every day to help our partners bring their innovations to patients worldwide, creating unparalleled access and impact at the center of health.1.) **Research the Company:** Thoroughly research any company before applying or sharing personal information, check their website, read reviews, and verify their legitimacy.2.) **Be Wary of Unrealistic Promises:** Exercise caution If a job posting offers high salaries and minimal qualifications. Legitimate jobs will have realistic expectations and provide detailed job requirements. Jobs at Cencora can be found on Cencora.com/careers3.) **Guard Your Personal Information:** Only share sensitive information after vetting the employer’s credibility. Avoid sharing your Social Security number, bank account details, or identification documents during the application process. Cencora does not request this information as part of the employment application.4.) **Avoid Upfront Payments:** Legitimate employers do not require payment during the hiring process. Be suspicious if you are asked to pay for training materials, processing fees, or background checks before securing a job offer. Cencora will never ask you for payment information during the hiring or onboarding process. Scammers often use free email services or chat platforms without providing an official company contact information. Cencora recruiters will have an email address ending in @cencora.com, @alliance-healthcare.net, @alliance-healthcare.co.uk, alliance-healthcare.fr or alliance-healthcare.ro
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