Case Manager - Patient Programs (Remote)

Sentrex Health Solutions is a growing provider of services within the life sciences industry. We partner with our clients to design and deliver logistic and service solutions at every stage of a product’s life cycle. We offer our clients:

• Customer Service support
• Specialty Pharmacy Services
• Customized solutions for Warehouse, Wholesale and Distribution
• We employ healthcare professionals and case managers to provide our clients with the best services in our industry, if you are the best at what you do then you should join our team.

Summary:

The Case Manager is responsible for managing all the aspects of the enrollment, reimbursement process, and service coordination for patients who has been prescribed the drug by physicians. The Case Manager will provide drug coverage support to physicians and patients, follow up on submissions pertaining to obtaining coverage through private and provincial drug plans, ensure patients have access to their prescribed treatments in a timely manner, and provide continuous support for patients through excellent communication skills and available resources to ensure patients have easy access to their prescribed therapy.

Primary Duties and Responsibilities:

• Responsible for the timely enrollment of the patient into the Patient Support Program.
• Collaborate with the patient, insurer, and physician regarding the documentation necessary for maximal reimbursement coverage, including the investigation of all public and private insurers and supporting employer escalations as required.
• Reviews the patient status and assists the prescribing physician to prepare documentation for public or private coverage by reviewing patient charts, assessing previous therapies and tests.
• Provides therapy guidelines/education on the program to manage patient and physician expectations.
• Collects information and conducts patient financial assessment eligibility based on program guidelines.
• Ensures patient services are coordinated and tracked in a timely manner resulting in quick and continued access to therapy.
• Reports Adverse Events/Severe Adverse Events (AE/SAEs) following approved SOPs.
• Maintain service levels in case management, including telephone answer rates, time to initiate contact with the patient, Adverse Events reported within twenty-four hours of receipt, and any other KPIs established as the Program level.
• Electronically updates the Customer Relationship Management (CRM) tool by providing timely patient and clinic information.
• Fosters and promotes a spirit of teamwork while working with internal patient support teams.
• Acts a liaison and provides ongoing feedback to the Program Manager based-on observations in the field and feedback from customers as it pertains to the quality of services, training, and other areas of importance.
• Identifies obstacles to obtaining coverage and channels this information to the Program Manager and/or Assistant Program Manager.
• Completes all relevant reports (timesheets, expenses, mileage, validate CRM reports, etc.) as per specified timelines and as per required standards.
• Additional duties as requested by the Manager.

Minimum Qualifications:

• A Bachelor’s degree
• 1-2 years of experience in a Patient Support Program
  
• Must reside in British Columbia
• Experience with reimbursement billing, special access, the appeals process, and conducting field-based reimbursement support and consultation is an asset
• Knowledge of private and public reimbursement structure, systems, and the process is an asset
• Experience with rheumatology and GI is an asset
• Must be able to work from home and have a quiet, private home office space
• Excellent verbal and written communication skills in English
• Strong analytical skills including interpretation of regulation and legislation
• Advanced knowledge of the pharmaceutical distribution industry
• Excellent customer service, problem-solving, and conflict resolution skills
• Effective interpersonal skills
• Typing skills and ability to be a strong functional user of various computer-based programs
• Bilingualism (English and French) is an asset but not required

Sentrex Health Solutions recognizes the importance of immunization to protecting our staff, customers, and members of the community from COVID-19. As such, and subject to any obligations under applicable human rights legislation, it will be a condition of employment that all new hires have received all required doses of a COVID-19 vaccine approved by Health Canada. Successful applicants will be required to provide proof of full vaccination prior to their start date.

Why work at Sentrex Health Solutions

We are building an exciting organization and we want like-minded people to help us reach our vision. We are an entrepreneurial team – a flat organization that offers lots of autonomy and flexibility to be excellent at your job.

Aside from a chance to build something from the ground up, we are offering competitive salary and benefits and a great work environment. We are looking for a full-time, long-term employee and we’ll hire as soon as we meet the right person.

We look forward to seeing your application!