Summary
Overview
Work History
Education
Skills
Volunteer Experience
Languages
Timeline
Generic

Chelsey Larose

Toronto,ON

Summary

A dynamic Field Case Manager with proven expertise in patient advocacy and strategic issue resolution. Successfully streamlined patient enrollment processes, enhancing communication with healthcare professionals. Adept at data management and regulatory compliance, ensuring accurate documentation and risk assessment to improve patient outcomes. Committed to fostering collaborative relationships within multidisciplinary teams.

Overview

8
8
years of professional experience

Work History

Field Case Manager

AmerisourceBergen
Toronto, Ontario
02.2022 - Current
  • Serve as the single point of contact for the program with physicians
  • Educate physicians and/or their staff on various program services
  • Provide therapy guidelines to manage physician expectations with respect to reimbursement
  • Consult patient charts in order to effectively complete necessary paperwork to obtain coverage
  • Assist MDs in completing Special Authorization (SA) forms, enrolment forms, prescription renewals, and other documentation
  • Deliver regular updates to physicians regarding patient statuses.
  • Modify components to cater to both in-clinic and remote MD requirements.
  • Proactively foster continuous improvement by identifying risks.
  • Enhance team collaboration to streamline patient processes.
  • Maintained accurate records of client progress using electronic databases.
  • Attend designated meetings between physicians and sales representatives.
  • Engage in continuous Medical Education sessions and report newly introduced activities.
  • Frequent numerous medical offices regularly.
  • Document Adverse Events.
  • Execute adhoc duties as assigned

Reimbursement Specialist

Charlton Health
Hamilton, Canada
12.2021 - Current
  • Coordinated with Rheumatologist's, Dermatologists, Nurses, and Pharmacists to ensure timely coverage of patient treatments.
  • Guided patients in accessing Charlton Centre services, including pharmacy, lab testing, TB clinics, infusion clinics, injection clinics and physician referrals.
  • Supported treatment initiatives for multiple indications involving Humira, Rinvoq, Cimzia, Xeljanz and Otezla through coordination with PSPs.
  • Streamlined workflows and ensured effective assistance for Charlton medical staff.
  • Implemented patient onboarding by performing welcome call.
  • Facilitated accurate entry of data on PSP enrollment documents.
  • Coordinated prescreen testing such as TB skin tests, chest X-rays, blood work, and vaccines.
  • Ensured drug coverage is secured and medical clearance obtained from physicians.
  • Arranged face-to-face instructional programs for administering injections to patients.
  • Facilitated meetings for biologic counseling.
  • Streamlined logistics and ensured timely assistance during therapy period.
  • Served as primary liaison at Charlton Centre for clinical dermatologists.
  • Facilitated implementation and analysis of advanced biologic treatments including Skyrizi, Humira, Siliq, Ilumya, Enbrel, Infliximab, Stelara, Taltz, Temfya, Cosentyx and Cimzia.
  • Verify patients' eligibility against government Exceptional Access Program criteria for diagnosis and prescribed biologic medication.
  • Assessed drug coverage eligibility for patients under private insurance and provincial programs.
  • Reviewed physician clinical documentation and requested pharmacy dispensing histories to verify completion of mandatory drug trials.
  • Secured prescriptions necessary for vaccine administration.
  • Processed Prior Authorization and EAP requests by gathering essential data from EMR systems, including Accuro, Oscar, and Telus.
  • Generated follow-up tasks in Kroll and Accuro to ensure adherence to paperwork submission deadlines.
  • Fostered strong relationships with Patient Support Programs to guarantee comprehensive assistance during patient therapy.
  • Coordinated request bridging and acquisition of free-of-charge drugs from patient support programs to ensure timely patient treatments.
  • Reported adverse events using patient support programs and online submission tools.
  • Facilitated trust-building among patients, physicians, PSPs, and pharmacies through ongoing communication.
  • Facilitated consistent updates and communication with PSPs and physicians.
  • Participated in webinars hosted by physicians.
  • Conducted Kroll reports to monitor patient therapy status.

Health Services Manager

McKesson
Toronto, Canada
01.2018 - 05.2018
  • Served as primary liaison with health care professionals, pharmacies, and insurance companies across Quebec.
  • Demonstrated comprehensive expertise in private/public funding coverage across Canadian provinces and territories.
  • Handled daily patient caseload via phone and email.
  • Performed comprehensive evaluations of insurance plans to assess coverage details and determine eligibility.
  • Facilitated seamless transitions from program enrollment to therapy through effective coordination with patients, stakeholders, and healthcare providers.
  • Collected patient medical information via virtual enrollment process.
  • Conducted follow-ups with physicians to verify medication coverage.
  • Maintained precise logs of all communications and patient-related records within the database.
  • Handled escalation management when support exceeded program scope.
  • Collected and reported adverse events to pharmaceutical manufacturer.
  • Supported onboarding process through monitoring and evaluating trainee calls.

Reimbursement Specialist – Bilingual

McKesson Canada
Toronto, Canada
05.2017 - 12.2017
  • Facilitated patient enrollment in PSP via inbound and outbound calls for specialty medication.
  • Facilitated administrative support for patients, ensuring they received appropriate program assistance.
  • Conduct financial evaluations with insurance providers and patients to determine coverage options for prescribed medications.
  • Regularly evaluated, updated and maintained completeness of patient records in database.
  • Coordinated and acquired Special Authorization documents for submission to insurance companies.
  • Managed follow-up tasks by prioritizing them in the system before deadlines.
  • Contacted insurance companies and physicians directly to prioritize requests.
  • Facilitated seamless patient care through coordination of IV drug infusions and clinic schedules.
  • Scanned and attached documents, faxes, medical records, and post-infusion reports to patient files.
  • Promptly document and communicate adverse events to the pharmaceutical manufacturer.
  • Maintain strict compliance with confidentiality standards.

Education

Bachelor of Health Sciences - Honours Specialization in Health Sciences

University of Western Ontario
London, Ontario
01.2017

Mental Health Interactive Learning Module - Accomplishment in Mental Health Awareness

London, Ontario
01.2015

Skills

  • Strategic Issue Resolution
  • Patient enrollment
  • Patient advocacy
  • Case management
  • Data management
  • Documentation accuracy
  • Regulatory compliance
  • Effective communication
  • Risk assessment
  • Case assessment

Volunteer Experience

  • Motionball Special Olympics Canada Foundation, Volunteer/Event Coordinator, 01/01/15, 12/31/17
  • Big Brothers Big Sisters of Canada, Big Sisters Mentoring, 01/01/14, 12/31/17

Languages

  • Fluent in English
  • Fluent in French

Timeline

Field Case Manager

AmerisourceBergen
02.2022 - Current

Reimbursement Specialist

Charlton Health
12.2021 - Current

Health Services Manager

McKesson
01.2018 - 05.2018

Reimbursement Specialist – Bilingual

McKesson Canada
05.2017 - 12.2017

Bachelor of Health Sciences - Honours Specialization in Health Sciences

University of Western Ontario

Mental Health Interactive Learning Module - Accomplishment in Mental Health Awareness

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Chelsey Larose