Senior Case Manager (Remote)

Sentrex Health Solutions

3h • Remote

About The Position

Reporting to the Associate Program Manager, the Senior Case Manager is
responsible for delivering high-level case management, training, and support
services to a variety of programs and departments at Sentrex Health Solutions.

The Senior Case Manager is responsible for managing all the aspects of the
enrollment, reimbursement process, and service coordination for patients who
have been prescribed the drug by health care practitioners. The Senior 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.

The Senior Case Manager will be responsible for assisting with program training
needs and help to develop and maintain required training.

Requirements

• Bachelor’s Degree or College Diploma in a relevant field of study.
• 2-5 years of experience in Patient Support Programs with advanced knowledge of Case Management and the pharmaceutical distribution industry.
• Demonstrates an aptitude for continuous learning.
• Advanced knowledge of reimbursement billing, special access, the appeals process, and conducting field-based reimbursement support and consultation is required.
• Must be able to work from home and have a quiet, private home office space.
• Excellent verbal and written communication skills in English.
• Knowledge of private and public reimbursement structure, systems, and the process is required.
• Strong analytical skills including interpretation of regulation and legislation.
• Excellent customer service, problem-solving, and conflict resolution skills.
• Strong interpersonal skills.
• Strong functional user of various computer-based programs.
• Proficiency in Adobe Acrobat, SharePoint, and Microsoft Office applications is required.
• Strong ability to consistently meet deadlines and prioritize projects.
• Exceptional organizational skills and ability to activities both for self and others effectively.
• Ability to establish and build healthy working relationships and partnerships with peers.
• Ability to work independently, make decisions, multitask, and solve problems under a high degree of pressure.
• Flexible, resourceful, creative, and proactive work style with an enthusiastic attitude.
• Results-oriented with an ability to handle multiple tasks and maintain a high level of performance.
• Advanced ability to learn and understand new systems and software quickly.
• Excellent problem-solving skills: ability to resolve issues effectively and efficiently.

Nice To Haves

• Bilingualism (English and French) is an asset.

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 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 initial 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 Associate Program Manager based-on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance.
• Provides back-up assistance to PSP Supervisors, Associate Program Managers and Programs Managers when required.
• Identifies obstacles to obtaining coverage and channels this information to the Program Manager and/or Associate Program Manager.
• Recommends corrective actions to ensure deliverables are met.
• Collaborates and participates in PSP team and client meetings as necessary.
• Ensures access to therapy has been expedited determined by effective coordination and tracking, according to Program KPIs.
• Completes all relevant reports (time sheets, expenses, mileage, validate CRM reports, etc.) as per specified timelines and as per required standards.
• Responsible for the creation of work-instructions and training documents as required by the program.
• Aids with program pre and post launch-activities.
• Update and revise training content based on ongoing business needs.
• Deliver training content and facilitate learning sessions in person and virtually while using a variety of methods.
• Manage multiple projects with tight deadlines while providing valuable input to enhance and customize processes that exceed operational needs.
• Be a subject matter expert as it relates to the CRM and Case Management for Patient Programs at Sentrex Health Solutions.
• Shadowing of case managers to provide training and support as needed.
• Provide ad-hoc support to multiple programs, teams, and departments.
• Assists with data clean-up as required.
• Provide additional support with other duties or projects as requested by PSP Management

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
• Number of Employees: 101-250 employees