Spécialiste du soutien aux patients /Patient Support Specialist

Location:
1685 Tech Ave, Mississauga, Ontario, L4W 0A7
At Shoppers Drug Mart, we’re innovating health and wellness in Canada. From prescriptions to walk-in clinics, and a beloved loyalty program, we’re caring and supporting our customers in new ways every day.
With more than 1,300 locally owned and operated stores from coast to coast, the Shoppers Drug Mart network is more than a great place to shop, it’s a great place to work. We’re committed to building our talented team who champion collaboration, kindness and inclusivity. Join our team, and help recognize a healthy future for your career and for all Canadians.
Why this role is important?
Position Summary
The Patient Support Specialist is a senior individual contributor role within SHN's Central Program Operations team. This role serves as the primary point of contact for patients, caregivers, healthcare providers (HCPs), clinics, pharmacies, and enterprise partners across a portfolio of up to 70 Patient Support Programs.
Operating across all inbound omnichannel touchpoints — phone, email, and patient portal — the Patient Support Specialist manages complex reimbursement queries, program escalations, and patient access inquiries for both in-network and out-of-network interactions. This is a high-accountability role that requires deep knowledge of the Canadian payer landscape, PSP operations, and patient-centred service delivery.
This role supports one of the most complex PSP environments in Canada — 70 programs, 150,000+ patients, and a diverse stakeholder base spanning patients, caregivers, HCPs, pharmacies, clinics, and enterprise partners. The successful candidate brings both the technical expertise and the interpersonal depth to navigate that complexity with consistency and care.
Core Responsibilities
Inbound Patient and Stakeholder Support
Serve as the first point of contact for inbound inquiries via phone, email, and patient portal across all assigned PSPs
Provide accurate, timely, and empathetic support to patients, caregivers, HCPs, pharmacies, clinics, and enterprise partners
Navigate complex multi-program environments, applying the correct program protocols and eligibility criteria for each interaction
Manage high-volume inbound queues while maintaining service level standards and quality expectations
Triage and prioritize interactions based on urgency, clinical sensitivity, and program-specific requirements
Reimbursement Support — In-Network and Out-of-Network
Manage inbound reimbursement queries from patients, HCPs, pharmacies,.
Provide accurate guidance on coverage determinations, prior authorization (PA) status, co-pay and patient assistance program eligibility, and claims adjudication
Liaise with payers, insurers, and benefit managers to resolve complex reimbursement issues on behalf of patients and providers
Support patients navigating out-of-network access pathways including exceptional access, special authorization, and compassionate use programs
Document all reimbursement interactions accurately and completely in the case management system
Identify reimbursement trends and escalate systemic issues to the supervisor with supporting case data
Escalation Management
Receive, triage, and manage escalated inquiries from patients, clinics, physicians, pharmacies, and enterprise partners
Apply sound judgment in determining escalation pathways — clinical, reimbursement, operational, or compliance — and route accordingly
Own escalated cases from intake to resolution, maintaining proactive communication with all parties throughout
Recognize and escalate potential adverse event disclosures immediately per program pharmacovigilance protocols
Document escalation rationale, actions taken, and resolution outcomes in the case management system
Omnichannel Case Management
Manage interactions seamlessly across phone, email, and patient portal, maintaining consistent case continuity regardless of channel
Ensure all patient and stakeholder interactions are documented in the CRM with accuracy, completeness, and timeliness
Review prior interaction history before engaging with a returning patient or stakeholder to provide a connected, informed experience
Identify and flag gaps in omnichannel continuity to the supervisor for process improvement
Program Knowledge and Compliance
Maintain deep working knowledge of all assigned PSP program protocols, eligibility criteria, and service delivery standards
Stay current on changes to program design, payer policies, and regulatory requirements affecting PSP operations1
Adhere to all privacy, consent, and documentation obligations under PIPEDA, PHIPA, and program-specific requirements
Recognize and report potential adverse events, privacy incidents, and compliance concerns immediately per established protocols
Participate in program training, quality calibration sessions, and ongoing professional development
Quality and Continuous Improvement
Maintain individual quality scores at or above program benchmarks across all evaluation criteria
Participate in QA coaching sessions and apply feedback to continuously improve interaction quality
Identify recurring patient or stakeholder issues and contribute insights to process improvement initiatives
Support onboarding and knowledge transfer for new team members as required
Qualifications and Experience
Required
Minimum 5-7 years of experience in a Patient Support Program, specialty pharmacy, or healthcare contact centre environment
Deep knowledge of the Canadian payer landscape including private insurance, provincial drug benefit programs, special access, and out-of-network pathways
Demonstrated experience managing complex reimbursement inquiries for both in-network and out-of-network programs
Experience supporting multiple concurrent programs or therapeutic areas simultaneously
Proficiency with CRM and case management systems; experience with omnichannel contact centre platforms an asset
Strong written and verbal communication skills with the ability to navigate sensitive convers