Senior Caseworker

Cencora • Quebec, QC

2d

About The Position

The Senior Caseworker will work closely with assigned patients to identify reimbursement coverage options and investigate financial options for those without insurance. This role involves assisting with coaching and mentoring existing team members, managing a larger patient caseload than their counterparts, and serving as a reimbursement expert in their assigned territory. The Senior Caseworker will also provide assistance to other caseworkers with complex reimbursement, insurance, benefit investigation, special authorization, and appeal requests. Additionally, they will participate in special projects, provide daily support to Associate Program Managers, assist management with reports and program tasks, and collaborate with management to develop program protocols and Standard Operating Procedures (SOPs) for the Caseworker role. They will also lead training for new caseworkers, interact with insurance companies, physician's offices, and healthcare professionals, assist patients with clinic and pharmacy selections, schedule appointments, and generate drug orders. The role includes implementing call-center programs for telephone support, administering case-management protocols, implementing market research initiatives, documenting activities in a database, attending training, and reporting Adverse Events. The Senior Caseworker may also be assigned other duties as required.

Requirements

• A minimum of two (2) years experience in customer service; experience in medical, pharmaceutical and/or insurance industry is an asset
• Bilingual in French and English: written and verbal is an asset
• Highly organized with strong attention to detail
• Strong proficiency in Microsoft applications (Outlook, Word, Excel & PowerPoint)
• Flexibility in working shifts (hours of operation are 8 am - 8pm)
• Ability to apply critical thinking skills in order to solution problems
• A Minimum of 2 years experience working for a patient support program
• Experience working in a call center environment an asset
• Strong communication and interpersonal skills: written and verbal including effective phone etiquette to diverse audiences i.e. internal, healthcare professionals and patients
• Proven ability to manage time, set priorities and multi-task in order to meet various competing work deadlines
• Minimum University Degree in a related field or equivalent
• Advanced knowledge of pharmaceutical distribution industry
• Working knowledge of automated warehouse operating system
• Strong business and financial acumen
• Strong analytical and mathematical skills
• Ability to work in a fast paced environment and consistently meet deadlines
• Ability to communicate effectively both orally and in writing- fully bilingual
• Effective interpersonal and leadership skills
• Effective organizational skills; attention to detail
• Excellent problem-solving skills; ability to resolve issues effectively and efficiently
• Strong Knowledge of Microsoft Word, Excel, PowerPoint and other Office Programs
• Excellent leadership skills and training
• In-depth knowledge of patient support programs
• Responsible, dependable, and punctual
• Strong problem solving skills and demonstrates experience handling complex problems.
• Excellent people skills, team work, empathy, influencing others, adaptability.
• Strong technical skills and ability to learn new software/databases quickly

Nice To Haves

• experience in medical, pharmaceutical and/or insurance industry is an asset
• Bilingual in French and English: written and verbal is an asset
• Experience working in a call center environment an asset

Responsibilities

• Working closely with assigned patients’ to identify various reimbursement coverage options and investigate financial options for those without insurance.
• Assist with the coaching and mentoring of existing team members.
• Manage a patient caseload larger than their caseworker counterparts.
• Be a reimbursement expert in assigned caseload territory.
• Provides other caseworker(s) assistance with complex reimbursement, insurance, benefit investigation, special authorization, and appeal requests.
• Participate in special projects as assigned by the Program Manager.
• Provide daily support to Associate Program Manager(s)
• Assist management with various reports and program related tasks.
• Work with management to develop program protocol and SOP for Caseworker role.
• With management, lead training of new caseworkers, including but not limited to shadowing & call monitoring.
• Regularly Interacts with insurance companies, physician' offices, and healthcare professionals to provide optimal reimbursement support
• Assists the patient with Clinic and Pharmacy selections, and schedules patient appointments
• Generates drug orders ensuring that required information is faxed to the pharmacy, and related parties
• Adherence to the general company processes.
• Telephone Support : Implementing call-centre programs including the provision of patient, healthcare professional and funding bodies with telephone support. Current assistance lines focus on: Funding and access issues, including private, public and special access programs; Compliance programs
• Administer and adhere to case-management protocols, including clinical monitoring, data collection, on-going patient follow-up, compliance, therapy disruption/discontinuation monitoring, adverse event reporting and liaison with primary healthcare providers;
• Implementing pharmaceutical and biotechnology related market research initiatives with physicians, patients, pharmacists or other allied health professionals;
• All patient programs are based on casework methods and include a significant amount of out-bound calls.
• Document each activity in program specific database.
• Participate and attend on-going refresher training and in specialized training courses for specific products or programs as deemed appropriate by the manager.
• Clear communication to manager, pod, and program trained colleagues regarding the management of cases during foreseen absences.
• Responsible to report all Adverse Events to the assigned units/departments
• The Senior Caseworker will also be assigned other duties and tasks as required from time to time.

Benefits

• Cencora is committed to fair and accessible employment practices. When requested, Cencora will accommodate people with disabilities during the recruitment, assessment and hiring processes and during employment.

What This Job Offers

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