The Bilingual Reimbursement Specialist is a newly resourced capability that assumes responsibility for managing reimbursement related issues for patients requiring specialty medications. This role will act as the patient advocate and work closely with patients to navigate and secure potential sources of reimbursement. Together with the pharmacy services, this role will bring more convenience, lower spend, and better health outcomes to patients.
- Communicate and educate patients regarding their private drug coverage and options, including status of Prior Authorization requests.
- Gather all pertinent information, coordinate patient cases manage applications and liaise with the private, public, or manufacturer-sponsored drug funding programs to optimize reimbursement.
- Identify and resolve reimbursement issues to facilitate pharmacy processes including prescription processing and invoicing.
- Identify gaps and opportunities for clinical education and healthcare support, and liaise with the appropriate internal teams or external organizations to provide and enhance patient care.
- Gather information and maintain the specialty medication funding program database.
- Attend meetings with pharmaceutical companies and collaborate with Clinical Services to obtain in depth knowledge of the drug reimbursement landscape and funding mechanisms.
- Ensure accurate, thorough, and timely documentation of patient status within the operations systems.Comply to ESC policies and procedures to safeguard personal information (PI) and personal health information (PHI).
- Act as the subject matter expert for all stakeholders, including but not limited to physicians, payers, patients, caregivers, and manufacturers.
- Diploma or Bachelor’s Degree preferred
- 2-4 years’ experience in the pharmacy benefit management, insurance, pharmacy, biotechnology, or pharmaceutical industries; customer service and/or reimbursement.
- Demonstrated commitment to improve patient care
- Able to work independently and within a team
- Excellent written/verbal communication to include providing clear instructions
- Ability to multitask
- Strong problem-solving skills with the ability to resolve issues effectively and efficiently
- Knowledge of the private or public drug reimbursement would be an asset
- Knowledge of pharmacy dispensing software is preferred
- Computer proficiency in MS Office applications, with database experience a plus
- Bilingualism (French/English) is required
ABOUT EXPRESS SCRIPTS CANADA
Express Scripts Canada, a registered business name of ESI Canada, an Ontario partnership indirectly controlled by Express Scripts, Inc. (Nasdaq: ESRX), is one of Canada’s leading providers of health benefits management services. From its corporate headquarters in Mississauga, Ontario, just outside Toronto, Express Scripts Canada provides a full range of integrated pharmacy benefit management (PBM) services to insurers, third-party administrators, plan sponsors and the public sector, including health-claims adjudication and processing services, Home Delivery Pharmacy Services, benefit-design consultation, drug-utilization review, formulary management, and medical and drug-data analysis services, to better facilitate the best possible health outcomes at the lowest possible cost.
It will be a condition of employment that the successful candidate receives the Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation in order to receive Clearance if required.
We offer a competitive salary, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.
We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.
We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities. Thank you for your interest in this position, however only qualified candidates will be contacted for an interview. No telephone calls please.
For more information about Express Scripts Canada, visit its Web site at www.express-scripts.ca.