The Case Manager (CM) is responsible for managing all aspects of the reimbursement environment and program support for assigned physicians in the GTA. An expert in regional government payer policies and procedures, the CM supports the regional needs of the client and works directly with the in-house team to facilitate the enrolment, reimbursement and scheduling process to ensure patients have easy access to their prescribed therapy. The individual also assists the physicians in accessing the needs of each patient resulting in increased patient program enrollment and improved patient outcomes.
This role will be a combination of on-site work at various clinics as well as remote work.
Accountabilities include:
Practice Management
Patient Support
Mentorship/Peer Support
Client Interface
Participates in scheduled Key Opinion Leader (KOL) physician meetings with Sales Representatives;
Develops strong working relationships with physicians and physician office staff, providing additional office support to ensure smooth maintenance of patients enrolled in the program as needed;
Proactively provides assistance to resolve client issues with regards to assigned physicians;
Attends scheduled Continuous Medical Education events and reports new activities;
Provides in service presentation to KOL physicians in collaboration with the Sales Representatives on new program initiatives
Acts a liaison and provides ongoing feedback to the Patient Assistance Program based on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance;
Ongoing maintenance of communication with Program Manager, physicians, physician office staff, client representatives, patients and nursing team as required;
Qualifications:
Must have strong customer service experience;
Excellent interpersonal skills;
Case management experience preferred;
Experience and background in various therapeutic areas is an asset;
Experience in public or private third party reimbursement arena or pharmaceutical industry in sales, managed care, or clinical support is an asset;
Background in business administration (pharmaceutical) sales and marketing an asset;
Knowledge of private and public reimbursement structure, systems, and process is an asset;
Experience with reimbursement navigation, special authorization, appeals process and conducting field-based reimbursement support and consultation is an asset;
Valid Driver’s License, current auto insurance policy and access to reliable transportation, for regional travel.
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