• Job Description

  Req#: R108098

  At Ontario Health, we are committed to developing a strong organizational culture that connects and inspires all team members across the province. Our vision is that together, we will be a leader in health and wellness for all. Our mission is to connect the health system to drive improved and equitable health outcomes, experiences and value. How we work together is reflected through our five values: integrity, inspiration, tenacity, humility and care.

  What Ontario Health offers:

  Achieving your career goals is a priority to us. Benefits of working at Ontario Health may include the following based on employment type:

  • Fully paid medical, dental and vision coverage from your first day

  • a h ealth care spending account

  • a p remium defined benefit pension plan

  • three personal days and two float days annually

  • three weeks’ vacation to start (for individual contributors), increasing to four weeks after two years

  • c areer development opportunities

  • a collaborative values-based team culture

  • a wellness program

  • a hybrid working model

  • p articipation in Communities of Inclusion

  Want to make a difference in your career? Consider this opportunity.

  The PET Scans Ontario program coordinates PET scan services across the province, using an evidence-based approach to ensure appropriate access. PET scans in Ontario are available as predefined indications or through a case-by-case review program (PET Access) .

  The PET Analysts will support the team in administering the program's operations , specifically facilitating the reviews of requests through the PET Access Program. They will work closely with clinical expert reviewers, referring physicians, and PET centre staff across Ontario. They will support operational excellence that includes high - quality data collection, timely reviews of funding requests, and clear communication to stakeholders. They will also have an opportunity to design, test and implement a new provincial adjudication and reimbursement system and support the development and execution of a revised measurement plan.

  Here is what you will be doing:

  • Assesses, refines, tests, and maintains operational policies, processes, and procedures for reviewing and adjudicating PET Access applications.

  • Assesses, refines, tests, and maintains operational policies, processes, and procedures for reviewing and adjudicating PET Access applications.

  • Facilitates PET Access Program request evaluation, including:

  • Screens and prioritizes incoming requests for processing, including verification of administrative eligibility, redaction of confidential data, and data tracking.

  • Liaises with referring physicians and clinical expert reviewers to complete reviews of requests, including summarizing reviewer feedback into key points and/or actions for referring physicians.

  • Provides clear, consistent, accurate and timely written and verbal communications to stakeholders (e.g., patients, caregivers, physicians, public) concerning funding decisions, pricing, and policies.

  • Supports the procurement of new clinical expert reviewers and facilitates their training.

  • Manages the program telephone hotline and email inquiries by responding to patient-specific and general inquiries on PET scan services in the province.

  • Identifies and escalates risks to the Team Lead and proposes recommendations to address the issues identified.

  • Builds and manages relationships with clinical expert reviewers who provide clinical input and recommendations on the adjudication of cases.

  • Maintains accurate records in the programs’ tracking systems and software. Records include material of a confidential nature, including patient, physician and financial data.

  • Monitors trends in applications and provides input into provincial discussions around the expansion/ revision of eligibility criteria.

  • Supports funding to PET centres and clinical expert reviewers through data collection, analysis and reporting.

  • Supports the development of a measurement plan to monitor program operations that will enable operational excellence in program delivery.

  • Works with relevant clinical and program stakeholders to prepare for and present at meetings, as relevant (e.g., team meetings and/or expert clinician meetings).

  • Provides subject matter expertise to partners across Ontario Health as required, including collaboration with other departments (e.g., Technology Services, Privacy) to develop, enhance, and implement the program’s automated adjudication and reimbursement system by providing business requirements, facilitating requirement discussions with external users, completing user acceptance testing, and communicating launch and roll-out of the system across the province.

  Here is what you will need to be successful:

  Education and Experience

  • A university degree in Health Studies, Health Sciences, Health Systems, or equivalent.

  • 3-5+ years’ experience in a health care setting (e.g., hospital), government or agency, or other organization in the health sector.

  • Experience reviewing and understanding medical records, and being able to apply eligibility criteria to individual cases.

  • Knowledge of public healthcare systems and public health policies.

  Knowledge and Skills

  • Excellent English written and oral communication skills.

  • Demonstrates high attention to detail in all work processes, documentation, and deliverables.

  • Comfortable working in a dynamic and fast-paced environment with a high degree of variation and often competing priorities, with demonstrated ability to prioritize and multi-task to meet deadlines.

  • Experience working with clinicians and clinical subject matter, with a demonstrated ability to rapidly learn new subject matter and abstract key actions.

  • Takes initiative and anticipates needs of colleagues, manager, and stakeholders.

  • Ability to work independently using sound judgement and independent thought.

  • Confidence in making decisions and working independently yet seeking input when required.

  • Works collaboratively with others, supporting the needs and goals of the team.

  • Excellent interpersonal and customer service skills.

  • Demonstrated ability to build relationships with colleagues, clinicians, and other stakeholders.

  • Demonstrated history of using discretion in dealing with sensitive issues and maintaining appropriate levels of confidentiality.

  • Responsible and highly motivated; takes pride in their work.

  • Proficiency with computer software applications

  #LI-MD1

  #LI-hybrid

  Location:

  Toronto, Ontario (currently hybrid; subject to change).

  Employment Type:

  Permanent Full time

  Contract Length:

  N/A

  Salary Band:

  Band 4

  External Application Deadline Date:

  December 2, 2024

  All applicants must be a resident of Ontario to be considered for roles at Ontario Health.

  Ontario Health encourages applications from candidates who are First Nations, Métis, Inuit, and urban Indigenous; Francophone; members of Black and racialized groups; 2SLGBTQIA+ communities; trans and nonbinary individuals; and people living with disabilities.

  Ontario Health is an accessible employer and we offer accommodation in all aspects of employment, including the recruitment process. If you require a disability related accommodation in order to participate in the recruitment process, please contact us and a member of the team will connect with you within 48 hours.

• About the company

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