Bilingual Reimbursement Specialist
7 days ago
Reporting to the Team Lead of Clinical Pharmacists, the Coverage Navigation Specialist is responsible for day-to-day operations supporting the Clinical Services team.
Principal Responsibilities:
- Receive, handle and follow-up on Coverage Navigation applications
- Manage all aspects required to obtain prescription drug coverage for patients
- Maintain communication between internal and external stakeholders
- Coordinate cases with public and private payers, physician offices, pharmacies, and other relevant healthcare providers in order to maximize reimbursement options
- Coordinate all documents and related paperwork to private and public payers, as needed
- Liaise with internal stakeholders for report generation
- Respond to client inquiries related to Coverage Navigation cases and provide status updates
- Act as the primary resource of contact for members, internal partners and external clients
- Maintain high standards of professional practice by adhering to the ethics of the profession and keeping abreast of the latest professional advances
- Monitor Coverage Navigation cases to ensure goals are met on daily, monthly and quarterly basis
- Ensure continuity of care for cases is maintained and that any changes in application progress are clearly identified and transitioned accordingly
- Provide written and verbal communication to members, clients, and internal partners
- Identify process gaps, develop strategies to overcome operational challenges, and implement new processes as required
- Assume responsibility for personal and professional development
- Acquire and maintain extensive knowledge of private and provincial funding
Knowledge, skills and experience:
- Post-secondary education e.g., BSc and/or RPhT diploma
- Minimum 2 years' experience working in pharmacy setting
- Must be bilingual (English/French)
- Previous experience in pharmacy benefit management, insurance, and/or reimbursement is preferred
- Solid understanding of provincial and private drug plans for medication access
- Working knowledge of MS Office Applications – Word, Excel, PowerPoint
- Ability to organize, coordinate and prioritize own work
- Demonstrated capacity to liaise in a constructive and collaborative fashion with a variety of healthcare providers, clients and staff at various organizational levels
- Demonstrated strong ability to effectively communicate (verbal, written and presentation)
- Excellent analytical and problem-solving skills
- Demonstrated critical thinking, problem solving skills and attention to detail
- Demonstrated commitment to collaborative practice and lifelong learning
Employment is contingent upon the successful completion of a background check/police record check.
Job Type: Contract
Contract length: 17 months
Pay: $51,000.00-$56,000.00 per year
Benefits:
- Wellness program
- Work from home
Experience:
- Retail Pharmacy: 2 years (required)
Language:
- English and French (required)
Work Location: Hybrid remote in Mississauga, ON L5B 1M2
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