Patient Care Navigator - London, ON

Sentrex Health Solutions • London, ON

6d • CA$56,000 - CA$67,000 • Onsite

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, 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.

At Sentrex, we thrive when our people thrive. We are seeking a Patient Care Navigator - Neurology (Multiple Sclerosis) to help patients overcome the administrative and reimbursement barriers that can delay access to treatment. As the physician's primary reimbursement and patient-access partner, the PCN has a direct impact on how quickly patients secure coverage, begin prescribed therapy, and maintain continuity of treatment.

As a key member of the Clinic Solutions team, the PCN serves as the primary interface among the neurologist and clinic team, external manufacturer-sponsored patient support programs (PSPs), public and private payers, Sentrex Pharmacy, and patients or caregivers. The PCN coordinates the access journey from prescription and enrollment through reimbursement approval and first dispense, using urgency, sound judgment, empathy, accuracy, and persistent follow-through to resolve barriers and keep every patient moving forward.

Requirements

• Post-secondary education in healthcare, life sciences, pharmacy, business, or a related field, or an equivalent combination of education and relevant experience.
• Two or more years of experience in reimbursement navigation, a patient support program, specialty pharmacy, insurance, clinic coordination, or healthcare case management is required.
• Working knowledge of the Canadian public and private drug reimbursement landscape, including Exceptional Access, Special Authorization, prior authorization, coordination of benefits, and appeal processes.
• Experience working directly with physicians, clinic teams, patients, payers, PSPs, or specialty pharmacies.
• Demonstrated ability to manage a high-volume caseload, competing deadlines, and time-sensitive patient needs with strong organization and consistent follow-through.
• Strong analytical and problem-solving skills, including the ability to interpret payer criteria, identify missing information, and develop practical solutions to access barriers.
• Exceptional attention to detail and ability to complete paper and electronic forms accurately.
• Excellent verbal and written communication skills, with the judgment and empathy required to communicate effectively with physicians, clinic staff, patients, caregivers, and external partners.
• Self-directed and accountable, with the ability to work independently while collaborating effectively across a matrixed team.
• Proficiency with Microsoft Office and experience using CRM, ERP, case-management, or other healthcare technology platforms.
• Knowledge of privacy, confidentiality, pharmacovigilance, and standard operating procedure requirements within a healthcare or pharmaceutical environment.
• Ability to work remotely from a quiet, private home-office environment.

Nice To Haves

• Experience in neurology or multiple sclerosis is a strong asset; experience with specialty medications and complex reimbursement pathways is also valued.
• Bilingualism in English and French is an asset.

Responsibilities

• Serve as the physician and clinic team's primary reimbursement resource for patients prescribed multiple sclerosis therapies.
• Review new prescriptions, referrals, enrollment forms, and supporting clinical information for completeness and identify missing requirements immediately.
• Coordinate timely and accurate patient enrollment with the appropriate external manufacturer-sponsored PSP and confirm that the case has been received and activated.
• Assess and coordinate the most appropriate public or private coverage pathway, including benefits investigation, payer criteria review, coordination of benefits, and coverage sequencing.
• Prepare, review, and coordinate completion of Exceptional Access Program, Special Authorization, prior authorization, insurer, and other reimbursement forms in collaboration with the physician, clinic team, payer, and PSP.
• Draft or coordinate coverage appeals and supporting documentation when required, ensuring submissions clearly address payer criteria and identified gaps.
• Coordinate financial assistance, copay support, bridge access, free-goods programs, and other available solutions to minimize avoidable treatment delays and patient financial barriers.
• Maintain end-to-end visibility and accountability for open reimbursement cases, actively follow up on outstanding items, and escalate barriers that could delay coverage or treatment initiation.
• Act as the single point of contact for reimbursement-related communication between the clinic and external PSPs, creating a clear and efficient workflow for the physician and clinic team.
• Provide proactive, accurate, and actionable patient-status updates to the physician and clinic team, including outstanding requirements, next steps, risks, and expected timelines.
• Actively manage PSP handoffs and follow-up activity rather than relying on passive status updates; clarify ownership, due dates, and escalation paths for every outstanding action.
• Protect physician and clinic capacity by anticipating documentation requirements, preparing forms, organizing information, and clearly identifying decisions or signatures required from the clinic.
• Build trusted working relationships with neurologists, clinic staff, PSP case managers, payer contacts, pharmacy teams, and internal partners to support a coordinated patient experience.
• Identify recurring reimbursement barriers, workflow gaps, or service issues and recommend practical improvements that shorten time to treatment and improve clinic satisfaction.
• Partner closely with Sentrex Pharmacy to confirm that prescriptions, coverage approvals, financial assistance, patient consent, and other dispensing requirements are complete and current.
• Coordinate the timing of first and ongoing dispensings with the patient, clinic, PSP, and pharmacy to support the prescribed treatment plan and avoid preventable delays.
• Identify and escalate risks related to coverage, prescription validity, renewals, refill timing, product availability, patient contact, or other requirements that may affect dispensing or continuity of therapy.
• Ensure the clinic and patient receive timely communication when an issue may affect treatment start or ongoing access, with clear ownership of the actions required to resolve it.
• Serve as an accessible, knowledgeable resource for patients and caregivers with non-clinical questions about enrollment, reimbursement, financial assistance, pharmacy coordination, and next steps.
• Explain complex reimbursement and pharmacy processes in clear, respectful, and easy-to-understand language, recognizing that patients may be navigating a new diagnosis or treatment change.
• Provide proactive updates so patients understand the status of their case, what is outstanding, and what to expect next.
• Recognize the boundaries of the role, avoid providing clinical advice, and promptly direct clinical or medication-related questions to the appropriate healthcare professional.
• Document all patient interactions, reimbursement activity, decisions, outstanding actions, and status changes accurately and promptly in the designated Customer Relationship Management (CRM) or case-management system.
• Manage a high-volume, time-sensitive caseload by prioritizing urgent treatment starts, aging tasks, expiring authorizations, renewal requirements, and patients at risk of interruption.
• Meet established service levels and contribute to key performance measures, including enrollment-submission timeliness, time to coverage decision, approval-to-first-dispense time, task aging, and documentation accuracy.
• Maintain complete, accurate, and audit-ready records and follow all privacy, confidentiality, consent, quality, and records-management requirements.
• Report Adverse Events, Serious Adverse Events (AEs/SAEs), product complaints, and other reportable information in accordance with Sentrex policies, client requirements, and standard operating procedures.
• Collaborate with Clinic Solutions, Pharmacy, PSP, Operational Excellence, and other internal teams to resolve patient-specific issues and improve workflows across the MS patient journey.
• Provide feedback to the Manager on customer needs, payer trends, recurring access barriers, service quality, training opportunities, and operational risks.
• Complete required reports, administrative documentation, and other duties within established timelines and standards.
• Additional Tasks as assigned 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
• RRSP Matching Program
• Employee & Family Assistance Program

What This Job Offers

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