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Nurse Case Manager
3 months ago
About the RoleNurse Case Manager (NCM) will play an essential role in supporting patients living with HIV disease to improve both their health outcomes and quality of life.
Assist the physician with the completion of all program-specific paperwork and follow-up on submissions pertaining to obtaining drug reimbursement/coverage through private and provincial drug formularies to ensure patients have access to their prescribed treatments in a timely manner.
Act as a key resource to physicians who are prescribing this medication and continuous support for renewals, and coverage changes.
NCM will also supervise the coordination of monthly injection.This role is operated on a remote basis and is open to candidates that reside in Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, Quebec, Saskatchewan, Northwest Territories, Nunavut, and Yukon.
A Day in the LifeAssist in completing patient enrolment; including gathering all pertinent and appropriate information to complete the necessary forms (private and/or provincial insurance) in a concise, organized, and professional mannerLiaise and advocate with third-party providers and provincial governments as necessary to determine coverage optionsReview patient charts (paper and electronic based); keep electronic chartsEnsure patients are scheduled for necessary diagnostic tests and notify physicians of any expired test results that require follow-upsComplete Welcome Call activities with the patient according to defined scriptsReview Post Injection Reports to confirm next appointment is scheduled and data integrity of the report against the physician orderTrack missing Post Injection ReportsFacilitate any required communication with physicians, Patient Support Programs, or other health care professionals involved in the patient's circle of careFollow up/advocate until a decision is received, ideally securing coverage for the patientWork closely with the manufacturer local sales representatives to support specific physician's and staff needsOffer and/or provide educational training to patients and physicians on product's administrationAct as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinicsCoordinate and schedule patients at appropriate injection locations (home, clinic, etc.)
Provide updates to stakeholders based on observationsEnsure patient records are maintained and data-accurate to meet program reporting requirementsMust be able to identify and report Adverse Events to Health Canada, Med Info, and enter into source system and third-party systemsReport and document Adverse Events as per Pharmacovigilance requirementsParticipate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System as well as specific performance indicators for the projectMaintain confidentiality of client and corporate information and discuss same only with appropriate Bayshore personnelComplete all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore's policyComplete product complaint reportsAdhere to Bayshore and manufacturer Policies and ProceduresComplete other tasks, as requestedJob QualificationWhat You Bring to the TeamGraduate of registered Nursing Program or registered practical nursing program holding current registration from a provincial licensing body in Canada.
Minimum 2 years' experience in Patient Support ProgramsProviding excellent customer service skills internally as well as externallyMust be fluent in verbal and written communication and interpersonal skills for both English and French (Applicable for provinces/regions with French language service requirements)Preference with candidate that has experience with the productReimbursement experienceUnderstanding of provincial and private coverage criteria and how to navigate the Canadian drug coverage landscapeFamiliarity with the Special Authorization process for both public and private insurance in assigned territoryStrong computer and technical skills:
Excel, Word, Outlook, tablets, web portals/internet useStrong critical thinking and problem-solving skillsMaking decisions using sound judgmentAccurate data collection and dataEase with working in a paperless environmentAbility to drive for resultsProven ability to work in a team environmentAbility to resolve conflict in a professional matterStrong sense of organization and attention to detailSelf-regulation of time management and the ability to multi-task and adhere to deadlinesFamiliarity with PIPEDA and how it applies in a confidential patient environment
