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!
PRINCIPALES FONCTIONS ET RESPONSABILITÉS:
Communication quotidienne et continue avec le gestionnaire de programme ou le gestionnaire de programme adjoint pour les projets nouveaux et existants;
Coordonner les cas avec les médecins et les professionnels de la santé afin de préparer des soumissions répondant aux spécifications et aux critères spécifiques établis par les payeurs des secteurs public et privé.
Coordonner et gérer tous les aspects nécessaires à l'obtention d'une couverture des médicaments d'ordonnance pour les patients;
Coordonner les cas avec les compagnies d'assurance, les bureaux de médecins et les professionnels de la santé afin de maximiser les solutions de remboursement;
Parcourir le processus complexe de démarches pour obtenir une couverture pour les médicaments d'ordonnance et le remboursement de ces médicaments coûteux et qui sauvent des vies;
Coordonner les documents, les soumissions et tous les documents connexes aux compagnies d'assurance et aux 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
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:
Daily and ongoing communication with Program Manager / Associate Program Manager for new and existing projects;
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; and
The Reimbursement Specialist will also be assigned other duties and tasks as required from time to time.
What your background should look like
EXPÉRIENCE ET NIVEAU D’ÉDUCATION REQUIS:
Diplôme universitaire dans un domaine connexe;
Minimum de 3 ans d'expérience dans l'industrie pharmaceutique, l'assurance ou dans des secteurs liés aux soins de santé;
Expérience préalable en matière de remboursement et connaissance des remboursements publics, privés et fédéral est requise;
Minimum de trois (3) ans d'expérience en service à la clientèle, OU Cinq (5) ans ou plus d'ancienneté à titre de spécialiste de remboursement Sr.
Professionnel(le), courtois(e) et efficace au téléphone;
Excellente maîtrise des applications Microsoft (Outlook, Word, Excel);
Capacité démontrée à organiser son temps, à établir des priorités et à accomplir plusieurs tâches à la fois afin de respecter diverses échéances de travail concurrentielles;
Le/la candidat(e) doit posséder de solides compétences en communication et en relations interpersonnelles, y compris la capacité de communiquer avec les patients dans un contexte de soins de santé sur des sujets extrêmement délicats;
Capacité de travailler de façon autonome et en équipe;
Souci du détail; et
Bilinguisme, français/anglais.
COMPÉTENCES, CONNAISSANCES ET APTITUDES REQUISES:
Connaissance avancée de l'industrie pharmaceutique ou de l’assurance
Solide sens aigu des affaires et des finances
Solides compétences analytiques et mathématiques
Capacité de communiquer efficacement à la fois oralement et par écrit
Compétences interpersonnelles et de leadership efficaces
Sens de l'organisation; souci du détail
Capacité à respecter les échéances de façon systématique
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
University Degree in a related industry;
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.
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
Le candidat retenu pourrait avoir des contacts quotidiens avec des clients, des patients ou des pairs unilingues anglophones d'équipes interfonctionnelles.
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.
Schedule
Full time
Affiliated Companies:
Affiliated Companies: Innomar Strategies
Equal Employment Opportunity
Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.
The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.
Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned
Accessibility Policy
Cencora is committed to fair and accessible employment practices. When requested, Cencora will accommodate people with disabilities during the recruitment, assessment and hiring processes and during employment.
