Medication Reimbursement Specialist

Work Type: Temporary Full Time Drug Access Navigator / Medication Reimbursement Specialist (MRS) - Approx until July 31, 2026

Location: WRHN @ Midtown (formerly Grand River Hospital, KW Campus)

Home to seven regional programs and comprehensive health-care services, Waterloo Regional Health Network (WRHN, pronounced wren) is committed to meeting the current and emerging needs in Waterloo-Wellington and beyond.

WRHN is redefining the health-care experience through collaboration and innovation, addressing barriers to access, advancing care delivery, and setting new standards in compassionate, empowered community-driven health care.

At WRHN, every patient is at the centre of everything we do as we strive to improve lives, inspire healing, and build healthier, stronger communities. By listening to patients and partners, we strive to connect communities to the right care, at the right place, and at the right time.

Please Note: New employees must provide documentation/proof of COVID-19 vaccination status, a 2-step TB test, as well as proof of immunity to measles, mumps, rubella, and varicella (chickenpox) prior to their start date at Waterloo Regional Health Network (WRHN). New Employees will require clearance from Employee Health, Safety and Wellness before they are able to begin any position within WRHN.

Position Summary :

The Health Centre Pharmacy provides a unique opportunity to work with a multidisciplinary health care team in the provision of community pharmacy services. The primary function of the MRS is to act in a supporting role to facilitate the day-to-day investigation and reimbursement requests for patients at all locations affiliated with Grand River Hospital, with a significant portion of the work supporting the needs of the oncology program. In addition, services are provided to Hospital staff, volunteers and to patients of the Hospital’s specialty clinics and the Grand River Regional Cancer Centre. The Medication Reimbursement Specialist (MRS) is a key team member in marketing a customer-focused service. There will also be an evaluation of the impact of the MRS position on securing drug coverage, estimated cost savings to the patient, time to medication access and patient experience. The MRS will need to track the required data to analyze these metrics.

Responsibilities:

The Medication Reimbursement Specialist will:

• Meet with patients and/or patients’ caregiver(s) and/or family to provide guidance and assistance with funding for prescribed medication.
• Understanding and interpreting hospital, provincial and private insurer formularies.
• Communicating with the oncology health care team to ensure access to oncology medication for all eligible patients and ensuring that the patients are informed of all funding options.
• Communicating with a variety of clinical programs to support patient access to required medications.
• Assisting in the investigation of un-funded, non-formulary drug requests and to expedite these requests in a timely manner to avoid delay in treatment for patients.
• Serve as a point of contact between the patients and/or patients’ caregiver(s) and/or family and all healthcare workers to facilitate the supply of medication to the patient and avoid delays in treatment for patients.
• Part of this process will include making refill reminder calls; communicating with the prescriber for updated prescriptions; tracking drug payment; monitoring special access programs to ensure authorizations are renewed prior to expiration date and to ensure proper processes are followed when dispensing these patient’s medication at the Health Care Centre Pharmacy (HCCP) and Cancer Centre Retail Pharmacy (CCRP).
• For patients filling their medication at HCCP or CCRP, the MRS will monitor the progress of the patient’s funding requests and preferred provider agreements with various drug plans; maintain detailed records of all interactions related to each patient’s funding request; and manage inventory of these special order medications.

Position Requirements:

• Registered Pharmacy Technician, Social Worker, or other Regulated Health Professional (or equivalent combination of education and experience).
• Minimum 5 years recent full time experience in retail pharmacy located in a hospital setting
• Minimum 2 years recent significant experience working with the McKesson Nexxys software system
• Minimum 1 year experience working in an Oncology Outpatient Pharmacy or similar setting
• Good attendance record

Preferred Requirements:

• Demonstrated ability to work independently, take initiative, skilled in following specific instructions with a high degree of accuracy
• Demonstrate the necessary skills for an excellent team player
• Demonstrated knowledge of public and private funding programs (third party drug insurance payers and assistance programs)
• Excellent problem-solving, time management, interpersonal and communication skills as well as being proficient in the English language
• Ability to be flexible and adaptable to changing priorities as required in order to address urgent issues

Application Instructions:

EMPLOYEES OF LEGACY ST. MARY’S GENERAL HOSPITAL ARE REQUIRED TO SUBMIT THEIR APPLICATION ELECTRONICALLY USING INFOR.

As per the collective agreement, the internal recruitment process will be completed prior to the consideration of external applications.

Waterloo Regional Health Centre is committed to fair and equitable employment and in our recruitment and selection practices. We strongly believe in inclusion and diversity within our organization, and welcome all applicants including, but not limited to racialized communities, all religions and ethnicities, persons with disabilities, LGBTQ2S+ persons, Indigenous people, and all others who may contribute to the further diversification of our Hospital community. We are committed to providing and fostering a respectful workplace for all employees, free from violence and harassment.

Accommodations are available during all stages of the recruitment process in accordance with the Human Rights Code. WRHN is committed to complying with the Accessibility for Ontarians with Disabilities Act (AODA) to provide an inclusive, barrier free workplace. We will accommodate the accessibility needs of individuals with disabilities to support participation in all aspects of the recruitment process. Should you require this accommodation, please contact Human Resources.

International Applicants

If you are seeking employment on a temporary work or study permit we recommend reviewing work permit restrictions as it applies to healthcare organizations in Canada. Individuals holding a work or study permit seeking employment in the healthcare sector may be required to complete additional steps in the process. This may also apply to current employees seeking renewal of their work permits. It is the accountability of the applicant and/or employee to ensure they are adhering to their specific work permit restrictions.

We would like to thank all candidates in advance for their interest and only those candidates selected for an interview will be contacted. Due to the volume of applications, we receive, we are unable to confirm the receipt of individual applications or resumes.