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New Job Bilingual Reimbursement Case Manager (Non-Nurse) In Quebec

Bilingual Reimbursement Case Manager (Non-Nurse)
Bilingual Reimbursement Case Manager (Non-Nurse)

Bilingual Reimbursement Case Manager (Non-Nurse)

Company : Bayshore HealthCare
Salary : Details not provided
Location : Quebec

Full Description


Ensure patient has been enrolled in the patient support program. Set the tone for a warm welcome into the program.
Provide direct telephone assistance to patients requiring reimbursement support
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 patient support program (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.
Liaise with PSP team to ensure optimal patient support and communication.
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.
Be a proactive catalyst for the continuous improvement of the experience offered to patients.
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 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 (if applicable) and enter into source system and third-party systems.
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 client and corporate information and discusses same only with appropriate Bayshore personnel.
Complete other tasks as requested.

Job Qualification


Post-secondary education or equivalent.
Reimbursement experience and/or a willingness to learn
Bilingualism Required
Understanding of provincial and private coverage criteria and how to navigate the Canadian drug coverage landscape
Familiarity with the Special Authorization (SA) process for both public and private insurance in assigned territory
Experience in the healthcare, pharmaceutical, or insurance industry would be an asset; experience with patients with cancer or rare diseases would also 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.
Demonstrates cultural competency.
Making decisions using sound judgment, and meeting deadlines.
Ease of working in a paperless environment
Proven ability to work autonomously within a team environment, in a remote/virtual setting
Strong sense of organization, attention to detail, and ability to multi-task
Comfortable working in a contact center environment.
Proficient in Microsoft Office applications (Outlook, Word, and Excel).