Reimbursement navigator, Patient Experience

Type:

1 year contract

Location:

Remote

Department:

Access, Policy & Patient Experience

Details:

Summary of Purpose

The Reimbursement navigator is an integral part of the Patient Experience team, working in close partnership with the team, and other outside Patient Experience service providers. The incumbent is responsible for the coordination and delivery of services related to the patient support programs offered by Otsuka Canada.  It involves supporting patients, nurses, physicians and other members of the Health Care team from a patient reimbursement journey perspective among other Patient Experience activities.  Moreover, this person will assist the Coordinator, Patient Experience in the coordination and administrative duties related to the ongoing functioning of the patient support programs/services.

The goal of this role is to partner with patients and the Health Care team to deliver an unparalleled customer experience with the most personalized and patient-centered care possible to ensure the best patient outcomes.

Responsibilities

Reimbursement Duties:

  • Liaise with physicians’ offices, patients as well as public and private payers to help to secure reimbursement of Otsuka medications in a timely fashion
  • Assess patient coverage status and conduct reimbursement investigations to help determine reimbursement eligibility
  • Present available patient financial assistance solutions for prescribed Otsuka medications
  • Complete special authorization forms and special documentation forms to ensure uninterrupted access to Otsuka medications
  • Document reimbursement activities at different points during the patient treatment journey into the Salesforce Health Cloud customer relationship management system

Coordinator/Administrator Duties:

  • Dispatch tasks to the appropriate Patient experience colleagues and/or Patient experience service providers
  • Perform HCP and patient enrolment activities according to program protocols and applicable departmental procedures
  • Answer incoming telephone calls to provide live support, and if needed, ensure follow-up with appropriate Patient Experience colleagues and/or Patient Experience service providers.
  • Manage the Patient Experience email inbox and incoming faxes and take action as per program protocol
  • Process reports related to the safety monitoring program

General Duties:

  • Ensure open dialogue with Otsuka Key Account Managers (specialty representatives) while protecting patient confidentiality
  • Follow the program protocols to ensure that the most appropriate next steps are scheduled to ensure continuity of service delivery to HCPs and patients
  • Report Safety Information, Product Quality Complaint and Customer Feedback as per Otsuka standard operating procedures
  • Exhibit an innovation and continuous improvement mindset. Provide feedback regarding current protocols, databases, processes and inter-departmental relationships
  • Act as a backup for the Coordinator, Patient Experience as well as the Clinical Liaisons, Patient Experience during vacations and/or extended leave of absences
  • Attend and actively participate in annual All-Company Meeting and national/regional meetings, as required

Qualifications and Key Competencies

  • Excellent written and verbal communication skills
  • Experience in a related field or in the pharmaceutical industry is an asset
  • Knowledge of the Canadian drug access system is a strong asset
  • Experience in assessing, exploring and implementing reimbursement solutions in Canada is an asset
  • Related technical diploma is a requirement. A Bachelor’s degree is an asset
  • Experience in the therapeutic areas of nephrology and/or mental health is an asset
  • Strong customer service, communication, and problem-solving skills required
  • Demonstrate ability to prioritize and complete tasks based on relative importance and urgency
  • Demonstrate professionalism and integrity, have a strong understanding of ethical practices and boundaries between roles of HCPs and pharmaceutical employees and ensure respect of confidentiality
  • Proficient in digital platforms (laptop, tablet, smart phone, email, databases, PowerPoint, Excel, Word, PDF editing) and open to newer evolving technology
  • Ability to work independently with great autonomy
  • Strong team player with the ability to work in a highly collaborative and fast-paced environment
  • Organized with a high attention to detail
  • Flexibility in working hours (up to 8pm occasionally). Ability to work evenings or weekends as needed (not frequent)
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