Bilingual Reimbursement Case Manager

**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.
- Follow-up/advocate until a decision is received.
- Proactively offer counseling, advocacy and assistance for patients.
- Liaise and advocate with third-party providers and provincial governments as necessary to determine coverage options.
- Complete Reimbursement Navigation & complete other tasks as requested
- Follow-up/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
- Bayshore is committed to a high quality and safe environment for both our staff and clients/patients. At Bayshore all new hires must have received the full series of a COVID-19 vaccine or combination of COVID-19 vaccines approved by Health Canada (e.g., two doses of a two dose vaccine series or one dose of a single
- dose vaccine series); AND have received the final dose of the COVID-19 vaccine at least 14 days prior to the official start date of hire. Medical exemptions or any other kinds of requested exemptions based upon Human Rights Code will be considered on a case-by-case basis. Bayshore operates in accordance with the Accessibility for Ontarians with Disabilities Act, 2005 and applicable Provincial Human Rights Code._

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 (asset)
- 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, web-portals/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
- Self-regulation of time management and the ability to multi-task and adhere to deadlines
- Familiarity with PIPEDA and how it applies in a confidential patient environment.