Language Therapy jobs

Gifthealth and Lily Canada Patient Support Program

MUST SPEAK FRENCH

*You would be hired as a Kelly Services employee, assigned to Gifthealth*

About Us

At Gifthealth, we're revolutionizing the way people experience healthcare by simplifying the process of managing prescriptions, patient support services, and medication access. Our mission is to provide a seamless, personalized, and efficient healthcare experience for patients, caregivers, healthcare providers, pharmacies, payers, and program partners. We're a dynamic, innovative, and customer-centric company dedicated to making a positive impact on people's lives.

Position Summary

The Bilingual (EN/FR) Drug Safety Specialist plays a critical, dual-purpose role at Gifthealth, serving as a frontline guardian for pharmacovigilance compliance while actively driving patient access and reimbursement workflows for the Lilly Canada Patient Support Program (PSP).

The primary focus of this non-clinical role is the vigilant identification, meticulous documentation, and rapid escalation of Adverse Events (AEs) and Product Complaints (PCs). Operating strictly within non-clinical boundaries, the Specialist ensures full compliance with manufacturer, client, and healthcare privacy standards. Concurrently, they act as a high-touch case manager—navigating complex Canadian public and private payer landscapes, resolving reimbursement barriers, and coordinating seamlessly with Healthcare Providers (HCPs), pharmacies, and patients to accelerate time-to-therapy.

Key Responsibilities

Core role: Compliance, Quality, Safety, and AE/PC Support

• Follow all applicable company policies, program requirements, client expectations, privacy requirements, and healthcare support standards.
• Maintain appropriate non-clinical role boundaries and escalate clinical, medication-specific, safety, or medical inquiry questions through the appropriate pathway.
• Support timely identification, documentation, and escalation of potential Adverse Events and Product Complaints in accordance with program-specific processes.
• Recognize patient, caregiver, HCP, pharmacy, or payer statements that may require AE/PC intake or escalation.
• Follow approved workflows to ensure AE/PC information is routed appropriately while maintaining non-clinical role boundaries.
• Document AE/PC-related activity accurately within the program system and escalate sensitive or urgent matters through the appropriate pathway.
• Prepare and/or assist with reports as requested, including adverse event and product complaint reports when applicable.
• Complete quality monitoring and quality assurance activities as assigned.
• Support audits, documentation reviews, workflow checks, and process improvement activities related to patient access and reimbursement support.
• Maintain accuracy, confidentiality, and professionalism when handling patient, HCP, pharmacy, payer, and program information.

Patient Access and Program Support

• Support patient access workflows for the assigned Lilly Canada Patient Support Program.
• Assist patients, caregivers, healthcare providers, pharmacies, and payers with moderate to complex access-related inquiries.
• Help identify and resolve access barriers related to insurance coverage, reimbursement requirements, missing documentation, HCP follow-up, pharmacy-related issues, or payer delays.
• Support patient enrollment, case review, coverage navigation, and program support workflows.
• Provide clear and professional support regarding program processes, access steps, reimbursement requirements, and case status.
• Review patient-specific eligibility for client patient support programs, financial assistance, or other access support services, as applicable.
• Reverify patient benefits at predetermined timeframes or as required by the program.
• Escalate complex access cases or unresolved barriers through the appropriate program pathway.

Reimbursement, Insurance, and Payer Support

• Complete benefit investigations and coverage reviews based on program requirements.
• Research and assess patient-specific insurance coverage options for assigned program products.
• Support payer outreach, reimbursement navigation, coverage verification, and insurance-related case follow-up.
• Support Special Authorization / prior authorization-related workflows, including payer follow-up and documentation review.
• Support appeal-related workflows when coverage or reimbursement barriers are identified.
• Review denied, delayed, or underpaid claims when applicable to the program workflow.
• Research public and private payer medical policies, coverage criteria, reimbursement requirements, and Special Authorization requirements.
• Monitor and update payer prior authorization requirements and coverage policies for assigned client program products.
• Identify trends related to payer denials, documentation gaps, coverage restrictions, appeal needs, or repeated access barriers.

HCP, Pharmacy, and Stakeholder Coordination

• Serve as a patient access resource for healthcare providers, HCP offices, pharmacies, payers, and other external stakeholders.
• Assist HCP offices with coverage, reimbursement, Special Authorization, documentation, and payer-related questions.
• Coordinate with pharmacies when pharmacy-related information, access barriers, or prescription support questions impact case progression.
• Interact with insurance payers to confirm coverage status, payer requirements, prior authorization criteria, reimbursement pathways, and policy updates.
• Manage patient cases and collaborate with external contacts, including payers, HCP offices, pharmacies, and other program stakeholders.
• Assist with coordination of relevant tasks and activities between Gifthealth, client program stakeholders, and external partners.
• Support escalated access or reimbursement cases requiring additional research, payer follow-up, or client/program review.

Case Management and Documentation

• Document all patient, payer, HCP, pharmacy, reimbursement, and access support activities in the program database within required timelines.
• Maintain accurate case notes, payer updates, follow-up dates, case status, and resolution details.
• Review case documentation to ensure required information is complete, accurate, and aligned with program expectations.
• Monitor assigned cases to ensure timely follow-up and appropriate case progression.
• Identify cases requiring escalation due to access barriers, payer delays, missing documentation, unresolved HCP follow-up, pharmacy-related issues, or program-specific exceptions.
• Support case reviews and help determine appropriate next steps based on payer requirements, program guidance, and documented case history.
• Assist with reporting needs related to case activity, reimbursement trends, payer barriers, access barriers, and program performance.

Client and Program Support

• Support communication and coordination with client contacts, program stakeholders, and internal Gifthealth teams.
• May serve as a program-specific access support contact for client or stakeholder inquiries.
• Provide patient access and reimbursement-related insight to internal teams based on payer trends, case barriers, and program needs.
• Participate in regular meetings with operations, quality, training, leadership, and program stakeholders to ensure alignment.

Qualifications

Education

• High school diploma or equivalent required.
• Completion of a relevant healthcare, pharmacy, reimbursement, patient access, hub services, or insurance training program preferred.
• Certified Pharmacy Technician, reimbursement certification, or healthcare access-related training preferred but not required.

Experience

• Health Canada experience is highly preffered
• Minimum of four years of recent healthcare experience required.
• Minimum of two years of direct patient access, reimbursement, hub services, payer support, pharmacy, or healthcare industry experience preferred.
• Experience supporting insurance benefit investigations, reimbursement navigation, prior authorization, Special Authorization, appeals, patient assistance programs, or payer policy research preferred.
• Experience working with patients, caregivers, HCP offices, pharmacies, payers, or program stakeholders preferred.
• Experience supporting specialty medication, chronic therapy, or complex access programs preferred.
• Client interaction experience preferred.
• High-volume healthcare support experience preferred.

Skills

• Bilingual French and English, REQUIRED
• Strong understanding of patient access workflows, benefit investigations, coverage review, payer follow-up, reimbursement navigation, prior authorization, appeals, and patient assistance support.
• Knowledge of medical insurance, public and commercial coverage, billing, coding, reimbursement terminology, and payer requirements.
• Advanced problem-solving, research, and analytical skills.
• Excellent customer service skills.
• Advanced written and verbal communication skills.
• Strong attention to detail and data entry accuracy.
• Ability to manage sensitive patient, provider, pharmacy, payer, and program information appropriately.
• Ability to multi-task, prioritize work, and manage time independently.
• Ability to navigate multiple systems while maintaining accuracy and productivity.
• Proficiency in Microsoft Office products, CRM platforms (Salesforce), case management systems, payer portals, and related technology.
• Ability to adapt to changing workflows, payer requirements, program updates, and client expectations.

Work Environment

• Location: Remote.
• Schedule: Full-time.
• May require availability or flexibility for escalations, program needs, client updates, or workflow support.
• Regular meetings with teams, departments, leadership, client contacts, and program stakeholders to ensure alignment.
• Work is performed in a healthcare operations environment where accuracy, confidentiality, documentation quality, timely follow-up, and patient experience are essential.

Pay: $62,000.00-$64,500.00 per year

Benefits:

• Dental care
• Paid time off
• Work from home

Experience:

• pharmaceutical industry: 3 years (preferred)
• Health Canada: 3 years (preferred)

Language:

• French (required)

Work Location: Remote