OBIO Job Board and Talent Network™️

Connect with highly skilled talent in the health science industry.

Spécialiste principal du remboursement / Senior Bilingual Reimbursement Specialist

Innomar Strategies

Innomar Strategies

San Jose, CA, USA · San Antonio, TX, USA · Houston, TX, USA · Phoenix, AZ, USA
Posted on Saturday, February 3, 2024

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!

What you will be doing

PRINCIPALES FONCTIONS ET RESPONSABILITÉS :

  • Agir comme chef d’équipe de tous les spécialistes du remboursement du programme et être une ressource pour ses collègues.

  • Communiquer quotidiennement et constamment avec le gestionnaire de programme ou le gestionnaire de programme adjoint au sujet des projets nouveaux et existants.

  • Évaluer constamment le processus de remboursement interne;

  • Perfectionner et maintenir les processus et les protocoles de remboursement à la demande du gestionnaire de programme ou du gestionnaire de programme adjoint.

  • Mettre en œuvre les processus et les protocoles avec le gestionnaire de programme et le gestionnaire de programme adjoint.

  • Mettre en œuvre les ICR du département selon les instructions du gestionnaire de programme et du gestionnaire de programme adjoint.

  • Surveiller et évaluer les activités du département liées aux ICR et fournir un rapport au gestionnaire de programme ou au gestionnaire de programme adjoint.

  • Être responsable de l’horaire et des quarts du gestionnaire chargé de la fermeture.

  • Coordonner et gérer tous les aspects requis pour obtenir une couverture des médicaments sur ordonnance pour les patients.

  • Coordonner les cas avec les compagnies d’assurance, les cabinets des médecins et les fournisseurs de soins de santé afin de maximiser les solutions de remboursement.

  • Coordonner la préparation et la soumission des documents et des données aux compagnies d’assurance ou aux programmes de financement publics ou fédéraux.

  • Appliquer le critère des ressources financières au besoin afin de maximiser la couverture des médicaments sur ordonnance des patients.

  • Coordonner les processus pharmaceutiques requis une fois que le financement a été obtenu;

  • Acquérir une connaissance approfondie des mécanismes de financement publics, privés et fédéraux.

  • Responsable de signaler tous les événements indésirables aux départements concernés.

  • Le spécialiste principal du remboursement se verra également confier d’autres fonctions et tâches au besoin, de temps à autre.

PRIMARY DUTIES AND RESPONSIBILITIES:

  • Act as a Team Lead to all Reimbursement Specialists within the rare diseases program by being a resource for them;

  • 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 submissions meeting specific specifications/criteria set by public/private payers

  • Navigate through the complex lobbying process to obtain prescription drug coverage and reimbursement for these life-saving and costly medications

  • Coordinate cases with insurance companies, physician’s offices and healthcare professionals in order to maximize reimbursement solutions

  • 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; an

  • Daily and ongoing communication with Program Manager / Associate Program Manager for new and existing projects

  • Ongoing evaluation of internal reimbursement processes

  • Reimbursement process and protocol development, maintenance, and implementation as assigned by the Program Manager / Associate Program Manager;

  • Implement, monitor and evaluate departmental KPIs as directed by the Program Manager / Associate Program Manager;

  • Responsible for closing manager schedule / shifts;

  • Provides sales training related to product reimbursement as appropriate.

  • The Senior Reimbursement Specialist will also be assigned other duties and tasks as required from time to time.

What your background should look like

EXPÉRIENCE ET SCOLARITÉ REQUISES :

  • Au moins trois années d’expérience dans l’industrie pharmaceutique, de la biotechnologie ou des soins de santé.

  • Une expérience en gestion de projets de TI est un atout;

  • Un diplôme universitaire dans un domaine connexe;

  • Une attitude professionnelle, courtoise et efficace au téléphone.

  • Le bilinguisme (anglais et français) est un atout.

  • Une expérience du service à la clientèle est un atout.

  • Une expérience des programmes de remboursement est également un atout.

  • De l’expérience dans l’industrie de l’assurance est également un atout.

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

  • University Bachelor Degree and/or combination of both educational and experience in a related industry;
  • Four (4) years in public or private third party reimbursement arena or pharmaceutical sales experience, hospital or MD office setting, managed care, or clinical support, or related experience, an asse
  • Knowledge of public, private and federal reimbursemen
  • Minimum of 3 or more of tenure as a Sr. Reimbursement Specialist
  • Experience in Rare Disease can also be required
  • Ability to lead a team and provide direction
  • Candidate must have strong communication and interpersonal skills, including the ability to communicate with patients in a healthcare setting on extremely sensitive topics
  • 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
  • Ability to work independently and in a team environment
  • Attention to detail; an
  • Bilingualism, French/English is an asset.

COMPÉTENCES, CONNAISSANCES ET APTITUDES REQUISES :

  • 1. Connaissance avancée de l’industrie de la distribution pharmaceutique

  • 2. Solide sens aigu des affaires et des finances

  • 3. Solides compétences analytiques et mathématiques

  • 4. Capacité de communiquer efficacement à la fois oralement et par écrit

  • 5. Compétences interpersonnelles et de leadership efficaces

  • 6. Sens de l’organisation; souci du détail

  • 7. Capacité à respecter les échéances de façon systématique

  • 8. Excellentes aptitudes en résolution de problèmes; capacité à résoudre les problèmes de façon efficace et efficiente.

  • 9. Excellentes compétences en matière de présentation.

  • 10. Connaissance de Microsoft Word, Excel, PowerPoint et d’autres programmes Office

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

  • Advanced knowledge of pharmaceutical, or insurance industry

  • Strong business and financial acume

  • Strong analytical and mathematical skill

  • Effective interpersonal and leadership skill

  • Effective organizational skills; attention to detai

  • Ability to consistently meet deadline

  • Excellent problem-solving skills; ability to resolve issues effectively and efficiently

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.

For details, visit https://www.virtualfairhub.com/amerisourcebergen

.

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.

AmerisourceBergen 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@amerisourcebergen.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

AmerisourceBergen is committed to fair and accessible employment practices. When requested, AmerisourceBergen will accommodate people with disabilities during the recruitment, assessment and hiring processes and during employment.