Patient Services Specialist

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Job Summary

The Patient Services Specialist is an integral part of the Patient Services team, responsible for providing administrative & patient counseling support to physician offices primarily to assist with the completion of paperwork and follow up on the submissions pertaining to obtaining drug reimbursement through private and provincial drug plans, relating to the patient support programs offered by McKesson Specialty. The focus of this position is to shorten the approval time for patients who are waiting to start therapy as well as providing value-added services in terms of time and resources to prescribing physicians on an as-needed basis. The role involves interactions with patients, insurance companies, pharmacies, physicians and other health care professionals (HCPs) to explore and obtain coverage for the prescribed medication as well as management of the patient cases.

This role is a full time, permanent position with rotating evening shift (12pm-8pm) availability required.

Specific Responsibilities

• Liaise with the patient, insurer and physician regarding the documentation required for maximum reimbursement coverage, including the exploration of all public and private insurers and providing employer escalations as required
• Responsible for escalation management in cases where assistance beyond program scope is required
• Gather all pertinent and appropriate information from the patient chart and complete necessary documents in a concise, organized and professional manner and submit physician signed forms to the private and/or provincial drug benefit insurer/agency
• Follow up with applicable insurers until a decision is received, with the intent of expediting a decision where possible. If the submission has been denied, the Senior Patient Services Specialist will discuss this with the physician and resubmit if agreed upon
• Updates with respect to the reimbursement submissions, confirmation of coverage and re-submissions will be entered into the patient database
• Complete follow ups with patients on behalf of the physician offices, as required, to ensure adherence to treatment regimens
• Provides information and updates to physicians and staff in their offices regarding the medication in terms of new criteria and indications as received from McKesson Canada or the Client
• The Bilingual PSS may be asked to do stretch assignments for the client
• Assist with client escalations for the program as needed
• Provide support to the team by answering any questions, problem solving and assigning tasks
• Provide support to PM/APM by assisting in tasks such as; authoring deviations, call reviews privacy incidents and AE reconciliations as requested.
• Act as a SME for the program, assists in the development of training material for the team if needed.
• Continuously provide best practice guidance to the team
• Receive, record and report Adverse Events as per the Pharmaceutical Manufacturer requirements
• Participate and assist in departmental continuous improvement activities related to process, quality, training etc.
• Maintain service levels in case management, including Adverse Events reported within twenty-four hours of receipt and any other Key Performance Indicators established at the Program level
• Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, general administrative functions including faxing, filing, scanning.

Key Competencies

• Strong customer service, communication, and problem solving skills
• Proficient in Microsoft Office applications (Word/Excel)
• Team Player and comfortable working independently
• Thorough knowledge of adult learning principles and training.
• Organized with a high attention to detail
• Understands and applies techniques to manage multiple priorities
• Possesses a high level of motivation to achieve necessary involvement within a team

Requirements

• 1+ years of prior Patient Support Program (PSP) experience
• Prior knowledge and experience with reimbursement is required
• University or college degree in a healthcare related field

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

Our Base Pay Range for this position

$46,100 - $76,800

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.