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Gestionnaire principal, Produits et processus de remboursement/ Senior Manager, Reimbursement Products and Processes
Gestionnaire principal, Produits et processus de remboursement/ Senior Manager, Reimbursement Products and Processes-September 2024
Flexible / Remote
Sep 21, 2024
ABOUT CENCORA
Cencora is a leading global pharmaceutical solutions company that is committed to improving the lives of people and animals everywhere.
10,000+ employees
Healthcare, Healthtech
VIEW COMPANY PROFILE >>
About Gestionnaire principal, Produits et processus de remboursement/ Senior Manager, Reimbursement Products and Processes

  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 :

  1. Élaborer, mettre en œuvre et appuyer tous les produits et processus de remboursement chez Innomar, en gardant à l'esprit les objectifs de

  simplifications, rationalisation, automatisation et ajout de valeur.

  2. Soutenir le directeur, Remboursement, en matière de communication et de positionnement des produits de remboursement et offrir

  son expertise à l'équipe de Développement de nouvelles affaires.

  3. Élaborer des parcours approfondis d'autorisation préalable propres aux payeurs et indépendants des programmes, et repérer

  les possibilités de rationalisation et d'automatisation.

  4. Gérer le développement et la mise en œuvre de produits comme la trousse de défense des droits et d'appel et le programme de conversion.

  5. Gérer les pratiques exemplaires et les processus d'examen des options d'aide financière pour les Programmes.

  6. Trouver et promouvoir de nouvelles solutions et initiatives stratégiques novatrices en matière de remboursement.

  7. Offrir un leadership éclairé en matière de stratégie sur les payeurs et de pratiques exemplaires par des

  recherches continues sur le marché afin d'informer et d'optimiser les programmes et les solutions.

  8. Planifier ou contribuer à planifier les rencontres régulières avec les spécialistes et les gestionnaires du remboursement des Programmes afin

  d'assurer l'échange continu de pratiques exemplaires.

  9. S'assurer que tous les projets de remboursement font l'objet d'une surveillance à des fins d'amélioration et de mesure du rendement.

  10. Établir des liens de collaboration avec les Programmes, les Pharmacies et Apprentissage et Rendement.

  11. Programmer les examens de données, les validations des mécanismes de couverture et des statuts de remboursement, trouver ou fournir

  des solutions aux problèmes potentiels de couverture, faire des recommandations aux Programmes pour la mise en œuvre de processus.

  12. Établir des processus robustes de détection, de suivi, de déclaration et de règlement des problèmes de

  remboursement émergents.

  13. Contribuer à créer des indicateurs de rendement clés (ICR) et de mesures pour suivre les activités de relation avec les payeurs, analyser

  les données de rendement et produire des rapports utiles à l'intention de la haute gestion.

  PRIMARY DUTIES AND RESPONSIBILITIES:

  1. Develop, implement and support all reimbursement products and processes across Innomar, keeping the goals of Simplification, Streamlining, Automation and adding value top of mind.

  2. Support Director, Reimbursement in communicating and positioning reimbursement products and provide expertise to the New Business Development team.

  3. Develop in-depth, program agnostic payer specific prior authorization journeys, identifying areas of opportunity for streamlining and automation.

  4. Drive development and implementation of Products such as Advocacy and appeals toolkit, conversion program.

  5. Manage and advise on financial assistance navigation best practices and processes for Programs.

  6. Identify and promote new innovative solutions and strategic initiatives for reimbursement.

  7. Drive thought leadership on the Payor Strategies and best practices through ongoing competitive market research to inform and optimize programs and solutions.

  8. Implement and/or assist with regular meetings with Programs' Reimbursement Specialists and Managers to ensure the consistent sharing of "Best Practices".

  9. Ensure that all reimbursement projects are monitored for performance improvement and achievement.

  10. Lead and develop a collaborative relationship with Programs, pharmacy and Learning and Development.

  11. Program data review, mechanism of coverage and reimbursement status validation, identification of and/or provide solutions to potential coverage issues, recommendations for Program process implementation.

  12. Develop robust identification, tracking, reporting and solutioning processes for emerging reimbursement issues challenges and/or issues.

  13. Help to establish key performance indicators (KPIs) and metrics to track payer relations activities, analyze performance data, and generate insightful reports for senior management.

  What your background should look like

  EXPÉRIENCE ET NIVEAU D'ÉDUCATION REQUIS :

  • Baccalauréat

  • 5 années et plus d'expérience dans l'environnement d'un PSP ou d'un payeur

  • ‌Connaissance approfondie de l'industrie pharmaceutique

  • Expertise avancée de l'environnement des payeurs publics et privés au Canada

  Sens aigu des affaires et des finances

  • Excellentes aptitudes de pensée analytique et critique

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

  ‌• Compétences interpersonnelles et de leadership efficaces, aptitudes de collaboration manifestes

  ‌• Sens de l'organisation; souci du détail

  ‌• Capacité à respecter les échéances de façon systématique

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

  ‌• Excellentes aptitudes de présentation

  ‌• Connaissance de Microsoft Word, Excel, PowerPoint, Teams et d'autres programmes Office

  ‌• Excellente connaissance des plateformes de GRC.

  COMPÉTENCES, CONNAISSANCES ET APTITUDES REQUISES :

  ‌• 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

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

  Excellentes aptitudes de présentation

  ‌• Connaissance de Microsoft Word, Excel, PowerPoint, TEAMS et d'autres programmes Office

  ‌• Excellente connaissance des plateformes de GRC.

  EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

  • Bachelor's degree

  • 5+ years in a PSP environment or Payer environment

  • Advanced knowledge of pharmaceutical industry

  • Deep expertise in Canadian public and private payer environment

  • Strong business and financial acumen

  • Strong analytical and critical thinking skills

  • Ability to communicate effectively both orally and in writing

  • Effective interpersonal and leadership skills, proven collaborator

  • Effective organizational skills; attention to detail

  • Ability to consistently meet deadlines

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

  • Excellent presentation skills

  • Extensive knowledge of Microsoft Word, Excel, PowerPoint, Teams and other Office Programs

  • Strong working knowledge of CRM platforms

  MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

  • Ability to communicate effectively both orally and in writing

  • Effective interpersonal and leadership skills, proven collaborator

  • Effective organizational skills; attention to detail

  • Ability to consistently meet deadlines

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

  • Excellent presentation skills

  • Extensive knowledge of Microsoft Word, Excel, PowerPoint, Teams and other Office Programs

  • Strong working knowledge of CRM platforms

  #LI-AA1

  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 [email protected]. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned

  COVID-19 Vaccine Policy

  As of October 18, 2021, Cencora requires all Canadian team members to be fully vaccinated and show proof of completed vaccine status at time of hire. If you cannot receive the COVID-19 vaccine due to a qualifying medical condition or sincerely held religious belief you will be required to follow AmerisourceBergen's policy and process to apply for an exemption/accommodation.

  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.

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