Pharmacy Technician - Medication Reimbursement Technician

Trillium Health Partners • Mississauga, ON

5d • CA$31 - CA$36 • Hybrid

About The Position

Reporting to the Manager of Outpatient Pharmacy, the Medication Reimbursement Technician (MRT) works as part of the multi-disciplinary team at Trillium Health Partners outpatient oncology clinic. The MRT role is to assist patients in navigating various drug coverage systems, helping to secure funding by 3rd party drug plans and minimize costs to patients. Working within the interdisciplinary team, the primary focus of the MRT is to evaluate, facilitate and coordinate access to medications for oncology patients. The MRT facilitates access to medications via Manufacturer-sponsored Compassionate Use Programs, Manufacturer-sponsored Patient Support Programs (PSPs), Ontario Drug Benefit (ODB), 3rd party insurance companies and out-of-pocket private payment options. The MRT may also be requested to offer support to other programs within Trillium Health Partners (ie. inpatient floors) to help obtain specially funded drugs or gain access to patient support programs.

Requirements

• Registered Technician with the Ontario College of Pharmacists
• A minimum of 3 years’ experience in an outpatient/community pharmacy setting
• Strong working knowledge of reimbursement terms for provincial and private payers, including some experience with 3rd party payers and patient assistance/support programs
• Proven proficiency with computer including word processing, spreadsheet applications and email systems
• Excellent verbal and written communication skills
• Skilled in following specific instruction with a high degree of accuracy
• Excellent interpersonal, communication, teamwork, problem-solving and organizational skills
• Able to adapt to change and have excellent time management and the ability to balance competing priorities
• Ability to work independently using the resources set up within the or to resource on own
• Self-starter
• Skilled knowledge of all Public Funding options, ODB, TDP and Federal Programs.

Nice To Haves

• Knowledge of Kroll system preferred
• Knowledge of Cancer Care Ontario New Drug Funding Program guidelines, policies and procedures preferred
• 2 years of related clinical (e.g. oncology) experience, including awareness of cancer terms and chemotherapy regimens an asset
• Knowledge of the pharmaceutical industry an asset
• Experience with EPIC an asset
• Ability to speak another language an asset

Responsibilities

• Evaluates, facilitates, and coordinates access to medication assistance for oncology outpatients, and occasionally THP inpatients by request
• Assist and educate patients in exploration of drug funding routes through public and private support and funding options. (e.g., ODB, EAP, SAP, Trillium, Industry sponsored patient assistance programs, compassionate and third-party plans)
• Interviews patients/care support partner to complete a needs assessment for financial assistance for medications not covered by ODB or CCO’s new drug funding program
• Interprets eligibility criteria for various access programs and assists patients/care support partner in obtaining appropriate services, completing application procedures, etc.
• Ensures patients are aware of all public and private support and funding options available such as Ontario’s Trillium Drug Program (a branch of ODB) and Manufacturer-sponsored PSPs
• Identifies options for drug coverage and assists patients and physicians with the completion of appropriate enrolment and access forms
• Tracks status of special funding requests, coordinates submission of additional information when required and communicates with patients and the rest of the interdisciplinary team when request decisions (approvals or denials) are received
• Determines all possible access for patients by maintaining up-to-date awareness of available reimbursement programs
• Tracks all patient requests for support/funding and impending appeals
• Maintains record of discussions/correspondences with patient’s/care support partner and multi-disciplinary team
• Provides follow-up to physicians, patients/care support partner and involved members of the oncology team (charge nurses, pharmacists, clerks as applicable) to communicate outcomes (approvals, denials, appeals)
• Coordinates with Pharmacy Buyer regarding ordering and receiving of compassionate use drugs
• Participates in the non-funded approval process when no funding sources are available
• Coordinates, on the patient’s behalf, completion of forms/paperwork required to obtain drug access
• Submits completed forms to programs, including all applicable supporting documentation (submission methods may include emailing, faxing, or mailing, dependent on the program)
• Coordinates submissions to SADIE (the online submission program for ODB Exceptional Access Program (EAP) applications) on behalf of oncology patients and physicians, and provides rationale for request for coverage
• Fields EAP requests for information and monitors the status of EAP requests
• Tracks system for expiry of EAP approvals and follows up with renewal applications as required
• Acts as liaison and advocate for the patient with 3rd party payers
• Conducts ongoing follow-up of all form submissions and reimbursement paperwork for each program
• Maintains record of discussions/correspondence with outside stakeholders (e.g. status of request)
• Liaises with Drug Representatives to learn about new PSPs and stay current about existing PSPs (i.e. program changes and closures) and updates the team accordingly.
• Liaises with retail and specialty pharmacies (includes faxing prescriptions)
• Documents ordering and receipt of shipments and tracks inventory of compassionate drugs
• Assists with other duties as required to support the oncology program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed