Pharmacy Senior Case Manager responsible for ensuring workflow in Ophthalmology clinics. Collaborating with healthcare providers and managing patient access to medications to maximize treatment outcomes.
Responsibilities
Creates the patient profiles (pharmacy)
Ensures the EF are complete - sends to the PSP (PSP creates Luminav profile)
Calls patient to welcome them into the program
Serve as a patient advocate by collaborating with healthcare providers and insurance companies to ensure access to appropriate medications and minimize out-of-pocket expenses
Assist with SA completion and facilitate the submission of SA to the Insurance provider
Assist with the reconciliation of Free doses
Conducts Test bills
Reports Adverse Events / Severe Adverse Events (AE / SAEs) following approved SOPs
Provides daily oversight to ensure that prescription workflow for designated One Team clinics is completed in a timely manner and according to clinic specifications
Acts as the main point of contact to answer questions related to designated clinics from clinic, field and pharmacy staff while appropriately escalating concerns to the management team (Supervisor or a Program Manager)
Assists with Pharmacy Assistant duties and responsibilities including prescription entry/labelling/packaging, preparing shipping reports, following up on insurance billing issues, answering phones, scanning/filing of paperwork and arranging courier deliveries as required
Adherence to all relevant guidelines including the established Standard Operation procedures and all applicable regulatory requirements as set out by the applicable provincial pharmacy college
Attends and participates in staff meetings
Collaborate with the pharmacy, PSP (Case Manager), clinic and patient regarding the documentation necessary for maximum reimbursement coverage
Perform other duties as assigned by manager
Requirements
Post secondary diploma from Pharmacy Assistant program an asset
Previous work experience in a pharmacy setting a strong asset
Willingness to work in-person at the pharmacy
Proficiency with Kroll strongly preferred
Strong computer skills in Windows environments and MS Office (Excel, Word)
Strong verbal and written communication skills required
Ability to communicate in other languages an asset
Knowledge and understanding of specialty medications along with third-party billing issues an asset
Highly organized with strong attention to detail
Excellent communication and interpersonal skills to effectively collaborate with patients and healthcare professionals
Ability to prioritize, organize, and manage a caseload of patients efficiently
Knowledge of insurance plans, formularies, and prior authorization processes
Familiarity with pharmacy software systems and electronic health records
Commitment to maintaining patient confidentiality and adhering to ethical standards in healthcare
Benefits
Competitive Salary and generous vacation entitlement
Wellness Program (5 paid days off for your well-being!)
Paid Sick Days
Competitive Benefits Package including Dental & Extended Health Benefits, AD&D, LTD & Employee/Dependent Life Insurance
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