DUTIES AND RESPONSIBILITIES

• Provide exemplary courteous professional service to all program stakeholders.
• Works with Nurse Case Manager(s) to gather all pertinent and appropriate information to complete all necessary insurance forms (Private and/or Public) in a concise, organized, and professional manner.
• Represent the patient with private or public insurers to optimize drug coverage and assist with the completion of Special Authorization (SA) and/or Prior Authorization (PA) forms, when applicable.
• Liaise and advocate with insurance providers and provincial governments as necessary to determine coverage options.
• Complete insurance appeals as required.
• Follow-up and advocate until a decision is received to secure coverage for the patient.
• Coordinate with pharmacy drug coverage and dispensing. Troubleshoot any filling/billing issues as required.
• Provide ongoing support and assistance to ensure patient adherence.
• Identify, report and document Adverse Events as per Pharmacovigilance requirements.
• Participate in ongoing internal and/or external continuing education activities.
• Adhere to Bayshore Policies and Procedures.
• Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System as well as key performance indicators for the program.
• Participate in proactive Health & Safety activities while performing all duties.
• Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns.
• Maintain confidentiality of pharmaceutical partner(s) and corporate information and discusses same only with appropriate Bayshore personnel.
• Complete other tasks as requested.