Care Navigator (Remote)

Sentrex Health Solutions • ,

8d • CA$53,000 - CA$63,000 • Remote

About The Position

A proudly Canadian company, Sentrex Health Solutions is a fully integrated specialty distributor and patient support provider for pharmaceutical manufacturers, physicians, and their patients. We provide innovative solutions focused on ensuring patients have access and the support they need to maximize their treatment outcomes. We do this through strategic distribution models and patient support programs that are backed by powerful, integrated technology, a dedicated in-house creative agency, and experienced, cross-functional teams. Our core capabilities include Specialty Pharmacy Services, Customized Solutions for Warehouse, Wholesale & Distribution, Patient Support Programs, Strategic Creative Services as well as HCP & Clinic Services.

Come and join our team! But first, let us tell you why we love working here:

We are 100% Canadian with locations across the country
State-of-the-art facilities to provide high-quality products and services
The opportunity to be a part of a winning, high-performing team
Collaborative, engaging workplace culture – we are passionate about our
people!
Flexible working environment that promotes a healthy work-life balance
Diverse and inclusive culture where your talent and commitment to excellence
is welcomed and valued
High-growth environment that provides opportunities for learning and growth
supported by our Employee Development Program and industry-leading, in-house
corporate training offered throughout the year

The Opportunity:

The Care Navigator is responsible for managing all the aspects of the
enrollment, reimbursement process, and service coordination for patients
enrolled into the Patient Support Program (PSP). The Care Navigator will assist
physicians/clinics and patients with drug coverage, oversee submissions to
private and provincial drug plans, ensure timely access to prescribed therapies,
and provide continuous patient support using strong communication and available
resources.

Requirements

• Must be able to work from home and have a quiet, private home office space
• Excellent verbal and written communication skills
• 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

Nice To Haves

• Post secondary education with experience in healthcare is an asset
• Bilingualism (English and French) is an asset.
• Experience with reimbursement billing, special access, the appeals process, and providing support and consultation is an asset
• Knowledge of private and public reimbursement structure, systems, and the process is an asset

Responsibilities

• Act as the primary point of contact for all patient related elements of the PSP.
• Responsible for the timely enrollment of the patient into the Patient Support Program.
• Telephone support (including maintenance calls and adherence support both inbound and outbound as needed).
• 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.
• Liaise with physicians’ offices, pharmacies, infusion/injection services providers and other parties to provide comprehensive and coordinated service to patients and physicians and resolve issues as they arise.
• Ensures patient services are coordinated and tracked in a timely manner resulting in quick and continued access to therapy.
• Review, analyze and validate information provided by patients for accuracy and completeness to ensure initiation and continuation of services.
• Maintain service levels in case management, including telephone answer rates, time to initiate contact with the patient, Adverse Events reported as per SOPs, and any other KPIs established as the Program level.
• Maintains accurate and timely patient/clinic information within the Customer Relationship Management (CRM) system.
• Fosters and promotes a spirit of teamwork while working with internal patient support teams.
• Identifies obstacles to obtaining coverage and channels this information to the PSP Supervisor.
• Follow‐up/advocate until a decision is received, ideally securing coverage for the patient.
• Maintains confidentiality of patient, client and corporate information and discusses same only with appropriate personnel.
• Additional duties as requested by the Manager.

Benefits

• Competitive Salary and generous vacation entitlement
• Wellness Program (5 paid days off for your well-being!)
• Paid Sick Days
• Competitive Benefits Package including Dental & Extended Health Benefits, AD&D, LTD & Employee/Dependent Life Insurance
• Employee & Family Assistance Program
• RRSP Matching Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree