Bilingual Spécialiste de remboursement / Bilingual Reimbursement Specialist, Rare Diseases

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!

Job Details

Principales Fonctions et Responsabilités:

• Poste contractuel de 15 mois
• Coordonner et gérer tous les aspects requis afin d'obtenir la couverture de médicaments d'ordonnance pour les patients;
• Coordonner les cas avec les compagnies d'assurance, les cabinets de médecins et les professionnels de la santé afin de maximiser les solutions de remboursement;
• Coordonner les documents, les soumissions et tous les documents connexes aux compagnies d'assurance, programmes de financement public/fédéral;
• Mettre en œuvre le test de moyens financiers tel que requis dans le but de maximiser la couverture des médicaments d'ordonnance du patient
• Coordonner les processus de pharmacie requis lorsque le financement a été obtenu; et
• Acquérir une connaissance approfondie des mécanismes de financement public/privé et fédéral.
• Responsable de signaler tous les événements indésirables aux départements concernés.
• Le/la spécialiste de remboursement sera également affecté(e) à d'autres fonctions et tâches au besoin de temps à autre.

Primary Duties and Responsibilities:

• 15 Month contract role
• Daily and ongoing communication with Program Manager / Associate Program Manager for new and existing projects;
• Demonstrate in depth knowledge of rare disease program offerings, including the pathophysiology of the disease/product, therapeutic area, disease process, and mechanism of action; and how to apply rare disease SOPs;
• Exhibit in depth knowledge of public/private and federal funding mechanisms as well as Rare Disease funding bodies (US and Canada).
• Coordinate cases with physician and healthcare professionals in order to prepare submission meeting specific specifications/criteria set by public/private payers.
• Coordinate and manage all aspects required in order to obtain prescription drug coverage for patients;
• Coordinate cases with insurance companies, physician’s offices and healthcare professionals in order to maximize reimbursement solutions;
• Navigate through the complex lobbying process to obtain prescription drug coverage and reimbursement for these life-saving and costly medications;
• Coordinate documents, submissions and all related paperwork to insurance companies, public/federal funding programs;
• Implement Financial Means Test as required in an effort to maximize patient’s prescription drug coverage
• Coordinate pharmacy processes required once funding has been obtained;
• Responsible to report all Adverse Events to the assigned units/departments;
• The Reimbursement Specialist will also be assigned other duties and tasks as required from time to time.

Expérience et Niveau D’éducation Requis:

• Éducation post-secondaire ou l'équivalent dans une discipline connexe;
• Minimum de 2 ans d'expérience en service à la clientèle, dans un environnement de bureau;
• Solidemaîtrise des applications Microsoft (Outlook, Word, Excel);
• Manières professionnelles/courtoises/efficaces au téléphone;
• Capacité éprouvée à organiser le temps, fixer les priorités et à accomplir de multiples tâches afin de respecter les diverses échéances de travail concurrentes;
• Le candidat doit avoir de solides compétences en communication et en relations interpersonnelles;
• Capacité à travailler de façon autonome et dans un environnement d'équipe;
• Souci du détail;
• Expérience dans l'industrie des soins de santé, des produits pharmaceutiques ou de l'assurance est un atout; et
• Le bilinguisme, français/anglais est un atout.

Compétences, Connaissances et Aptitudes Requises:

• Connaissance avancée de l'industrie de la distribution pharmaceutique
• Connaissance pratique du système automatisé d'opération d'entrepôt
• Solide sens des affaires et sens financier
• Compétencesanalytiques et mathématiquessolides
• Capacité à communiquer efficacement oralement et par écrit
• Compétences interpersonnelles et de leadership efficaces
• Sens de l'organisation; souci du détail
• Capacité à respecter systématiquement les échéances
• Excellentes aptitudes de résolution de problèmes;Capacité éprouvée à résoudre les problèmes avec efficacité et efficience
• Excellentes aptitudes de présentation
• Connaissance de Microsoft Word, Excel, PowerPoint et d'autres programmes Office

Experience and Educational Requirements:

• Minimum of 3 years’ experience in the pharmaceutical, insurance or healthcare-related industries;
• Previous experience in reimbursement and Knowledge of public, private and federal reimbursement is required;
• Minimum of three (3) years’ experience in a Customer Service setting; OR Five (5) years or more tenure as a Sr. Reimbursement Specialist
• Professional / courteous / efficient telephone manner;
• Strong proficiency in Microsoft applications (Outlook, Word, Excel);
• Proven ability to organize time, set priorities and multi-task in order to meet various competing work deadlines;
• Candidate must have strong communication and interpersonal skills, including the ability to communicate with patients in a healthcare setting on extremely sensitive topics;
• Ability to work independently and in a team environment;
• Attention to detail; and
• Bilingualism, French/English is an asset.

Minimum Skills, Knowledge and Ability Requirements:

• Advanced knowledge of pharmaceutical, or insurance industry
• Strong business and financial acumen
• Strong analytical and mathematical skills
• Ability to communicate effectively both orally and in writing
• Effective interpersonal and leadership skills
• Effective organizational skills; attention to detail
• Ability to consistently meet deadlines
• Excellent problem-solving skills; ability to resolve issues effectively and efficiently

The successful candidate may have daily contacts with unilingual English-speaking customers, patients or peers from cross-functional teams.

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

Full time

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