Case Manager

Bayshore HealthCare


Date: 2 weeks ago
City: Remote, Remote
Contract type: Full time
Remote
Duties And Responsibilities

  • Ensure patient has been enrolled in the patient support program (PSP). Set the tone for a warm welcome into the program.
  • Provide direct telephone assistance to patients requiring reimbursement support.
  • Provide patients and physicians with direct toll-free number
  • Develop strong relationships with patients, caregivers, and their healthcare team by infusing confidence, trust, security, and relief.
  • Facilitate a patient’s access to a particular medication by offering reimbursement navigation services.
  • Investigate reimbursement options available to the patient and maximize the patient’s coverage via private and public payers, while minimizing the financial assistance offered through the PSP and/or out-of-pocket expenses for the patient.
  • Represent the patient with private or public insurers to optimize drug coverage and assist with the completion of Special Authorization (SA) and/or Prior Authorization (PA) forms, when applicable.
  • Coordinate with pharmacy drug coverage and dispensing. Troubleshoot any filling/billing issues as required
  • Liaise with PSP team to ensure optimal patient support and communication, if applicable
  • Maintain ongoing and transparent communication with the patient’s healthcare team.
  • Diligent record-keeping to ensure continuous care and exceptional customer and patient experience.
  • Uncover and proactively identify gaps and opportunities for improvement in patient experience.
  • Through patient-oriented solutions, manage challenging patient situations with empathy and patience.
  • Work with the site representatives to support specific customer needs.
  • Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics.
  • Provide updates to internal and external stakeholders as requested and required.
  • Perform data entry, answer inbound calls, make outbound calls, manage e-mail and fax software, and perform general administrative functions including faxing and filing.
  • Must be able to identify and report Adverse Events to Health Canada and enter into source system and third-party systems, as applicable
  • Report and document adverse events as per pharmacovigilance requirements.
  • Participate in ongoing internal and/or external continuing education activities.
  • Adhere to Bayshore Policies and Procedures.
  • Participate in quality activities and continuous improvement initiatives in keeping with the company’s Quality Management System as well as specific performance indicators for the project.
  • Participate in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate supervisor of any Health & Safety risks or concerns.
  • Maintains confidentiality of pharmaceutical partner(s) and corporate information and discusses same only with appropriate Bayshore personnel.
  • Complete other tasks as requested.

Qualifications

EDUCATION

  • Completion of post-secondary education or equivalent

Experience

  • Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset
  • Demonstrated expertise in delivering exceptional customer service and fostering positive relationships with internal and external stakeholders
  • Must be fluent in verbal and written communication and interpersonal skills for both English and French (Applicable for provinces/regions with French language service requirements)
  • Experience in the healthcare, pharmaceutical, or insurance industry would be an asset
  • Strong customer service, communication, problem-solving and interpersonal skills required.
  • Demonstrates sensitivity and commitment to utilizing a patient-centric approach; is adept to responding to a patient’s emotional, educational, and health literacy needs
  • Making decisions using sound judgment, and meeting deadlines.
  • Ease of working in a paperless environment.
  • Mindful of accuracy and thoroughness of data entry for reporting requirements.
  • Strong sense of organization, attention to detail, and ability to multi-task.
  • Excellent written and verbal communication and interpersonal skills.
  • Strong computer and technical skills: Excel, Word, Outlook, tablets, web portals/internet use
  • Ability to work in a quiet working environment with proven ability to work autonomously within a remote/virtual team environment
  • Established high speed internet access from home office.

Primary Location

Ontario

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