Senior Caseworker

Cencora

9d • $48,000 - $74,030 • Hybrid

About The Position

This role is in support of Cencora's patient and provider support and pharma commercialization services in Canada marketed through our Innomar Strategies business. The Senior Caseworker will work closely with assigned patients to identify reimbursement coverage options and investigate financial options for those without insurance. This role also involves coaching and mentoring team members, managing a larger patient caseload, and acting as a reimbursement expert for their assigned territory. The Senior Caseworker provides assistance to other caseworkers with complex reimbursement, insurance, benefit investigation, special authorization, and appeal requests, and participates in special projects as assigned. They provide daily support to Associate Program Managers, assist management with reports and program tasks, and collaborate with management to develop program protocols and SOPs for the Caseworker role. Additionally, they assist management in training new caseworkers, including shadowing and call monitoring. The role involves regular interaction with insurance companies, physician's offices, and healthcare professionals to provide reimbursement support, assisting patients with clinic and pharmacy selections, and scheduling appointments. The Senior Caseworker generates drug orders, ensuring required information is faxed to the pharmacy and related parties, and adheres to general company processes. The position also involves implementing call-centre programs, providing telephone support to patients, healthcare professionals, and funding bodies, focusing on funding and access issues, compliance programs, and administering case-management protocols. This includes clinical monitoring, data collection, patient follow-up, compliance, therapy disruption/discontinuation monitoring, adverse event reporting, and liaison with primary healthcare providers. The role may also involve implementing market research initiatives and conducting outbound calls for patient programs. All activities are documented in a program-specific database, and participation in ongoing training is required. Clear communication regarding case management during absences is essential, and the Senior Caseworker is responsible for reporting Adverse Events.

Requirements

• Minimum University Degree in a related field or equivalent Work Experience
• A minimum of two (2) years experience in customer service
• 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
• 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
• Demonstrates a strong work ethic, is reliable and shows initiative to purse new skills
• 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

• Identify various reimbursement coverage options and investigate financial options for patients 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.
• Provide 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.
• Lead training of new caseworkers, including shadowing & call monitoring.
• Regularly interact with insurance companies, physician' offices, and healthcare professionals to provide optimal reimbursement support.
• Assist the patient with Clinic and Pharmacy selections, and schedules patient appointments.
• Generate drug orders ensuring that required information is faxed to the pharmacy, and related parties.
• Adhere to the general company processes.
• Implement call-centre programs including the provision of patient, healthcare professional and funding bodies with telephone support.
• 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.
• Implement pharmaceutical and biotechnology related market research initiatives with physicians, patients, pharmacists or other allied health professionals.
• 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.
• Provide clear communication to manager, pod, and program trained colleagues regarding the management of cases during foreseen absences.
• Report all Adverse Events to the assigned units/departments.

Benefits

• medical
• dental
• vision care
• comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness
• support for working families
• backup dependent care
• adoption assistance
• infertility coverage
• family building support
• behavioral health solutions
• paid parental leave
• paid caregiver leave
• training programs
• professional development resources
• opportunities to participate in mentorship programs
• employee resource groups
• volunteer activities

What This Job Offers

• Job Type: Full-time
• Career Level: Senior