Gestionnaire de cas terrain / Bilingual Field Health Case Manager

Sentrex Health Solutions • Quebec, QC

12d • Hybrid

About The Position

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 and experienced, cross-functional teams. Our core capabilities include Specialty Pharmacy Services, Customized Solutions for Warehouse, Wholesale & Distribution, Patient Support Programs, and HCP & Clinic Services.

Reporting to the Field Supervisor, the Field Health Case Manager is responsible for managing various aspects of Program service coordination for patients who have been prescribed the drug by physicians. The Field Health Case Manager will provide Program services support to patients and clinics which may include, but not limited to, training clinics in Program services, patient enrolments, obtaining coverage through private and provincial drug plans, ensuring patients have access to their prescribed treatments in a timely manner, and provide continuous support for patients and clinics through excellent communication skills and available resources to ensure patients have easy access to their prescribed therapy. In addition to the above Field Health Case Management general responsibilities, the Field Health Case Manager is responsible for interacting with clinics face-to-face, other Program Personnel and client personnel in supporting all services offered by the Patient Support Program (PSP).

Requirements

• Completion of Post-secondary is required
• Bilingualism (English and French) is required.
• 3-5 years of experience in reimbursement and/or with Patient Support Programs required.
• Professional demeanor with proven ability to communicate effectively with internal and external customers and stakeholders
• Excellent interpersonal skills: ability to build and maintain good relationships with clinic personnel, internal Sentrex Health Services colleagues, and all client personnel
• Excellent verbal and written communication skills
• Must be able to work from home and have a quiet dedicated office space
• Strong analytical skills including interpretation of regulation and legislation
• Excellent customer service, problem-solving, and conflict resolution skills
• Typing skills and ability to be a strong functional user of various computer-based programs
• Must be willing to travel and have a valid driver’s license
• Must be able to lift and carry products up to 25 lbs.

Nice To Haves

• 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 of the pharmaceutical distribution industry is an asset

Responsibilities

• Utilize PSP-related applications and software to complete reports and facilitate completion of enrollment forms, reimbursement forms and other Program functions.
• Schedule and manage weekly clinic visits (or at such frequency as deemed appropriate).
• Support PSP dose reconciliation.
• Proactively assess the PSP services and make suggestions to enhance outcomes and quality of service.
• Complete relevant reports such as timesheets, expenses, mileage, validate CRM reports etc. as per established Program procedures.
• Train physicians and other clinic staff on PSP Service offerings.
• Determine, on a case-by-case basis, which PSP elements are necessary to satisfy the needs of the enrolled physician patients, subject to the limitations set out in contractual agreements with the client.
• Assist clinics in reviewing patient status and facilitating patient enrolment, as appropriate.
• Prepare and/or assist in the completion of Special Authorization submissions to the appropriate insurer by, among other things, reviewing patient charts, assessing previous therapies and tests.
• Request PSP materials such as program enrollment forms, clinic guides and patient printed materials from the client on an as-needed basis.
• Enroll patients into the PSP utilizing the appropriate enrolment forms, assist the clinics in preparing documentation for reimbursement of the drug prescribed through the appropriate insurer.
• Ensure patient services are coordinated and tracked, according to agreed upon program performance metrics, to expedite access to therapy.
• Provide clear and concise information regarding PSP services to assist patients and clinics, as appropriate or desired.
• Data entry of sensitive patient information, accuracy and completeness are crucial.
• Report Adverse Events/Severe Adverse Events following approved SOP’s.
• Follow Sentrex code of conduct and follow regulation and legislation.
• Act as a liaison and provide ongoing feedback to the Field Supervisor and Program Manager based on observations in the field and feedback from stakeholders as it pertains to the quality of service, training, and other areas of importance.
• Interact with the Field Supervisor, Field Program Manager, other Program personnel, as well as client personnel; regular collaboration with the Key Account Specialist (KAS) and the client to review PSP clinic needs and deliver optimal PSP service resolutions for patients and clinics, as required.
• Additional duties as determined by your 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