Bilingual Nurse Case Manager

2 weeks ago

Markham ON, York region, Canada Bayshore HealthCare Full time
About the Role

Bilingual Nurse 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. NCM offers enrolment and reimbursement support to physicians and to patients. 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 position is operated remotely.

A Day in the Life

Remotely assist the prescribing physician to complete patient enrolment; gather appropriate information to complete the necessary forms (private and/or provincial insurance) in a concise, organized, and professional manner.
Liaise and advocate with third-party providers and provincial governments as necessary to determine coverage options.
Ensure patients are scheduled for monthly injection.
Complete Welcome Call activities with the patient according to defined scripts
Facilitate any required communication with physicians, Patient Assistant Programs or other health care professionals involved in the patients’ circle of care.
Follow-up/advocate until a decision is received, ideally securing coverage for the patient.
Offer and/or provide educational training to patients and physicians on product’s administration
Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics and pharmacies.
Provide updates to stakeholders based on observations in the field and physician’s
Ensure patient records are maintained and data accurate to meet program reporting requirements.
Must be able to identify and report AE’s to health Canada, Med Info and enter into source system and third-party systems
Report and document Adverse Events as per Pharmacovigilance requirements
Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System as well as specific performance indicators for the project
Maintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel
Completes all relevant reports as per specified timelines and Bayshore’s policy
Complete product complaint reports
Adhere to Bayshore and manufacturer Policies and Procedures
Complete other tasks as requested
Job Qualification

What You Bring to the Team

Registered Nurse or Registered Practical Nurse (RN/RPN) License
Bilingual in French and English
Experience with private and public payer is a strong asset
Experience in HIV is an asset
Registered and in good standing with the College of Nurses
Minimum 2 years’ experience in Patient Support Programs
Providing excellent customer services skills internally as well as externally
Excellent verbal and written communication skills and interpersonal skills; English and French
Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.
Familiarity with the Special Authorization process for both public and private insurance in assigned territory.
Strong Computer and Technical skills: Excel, Word, Outlook, tablets, web-portals/internet use
Strong critical thinking and problem-solving skills
Making decisions using sound judgment, and meeting deadlines.
Accurate data collection and data integrity
Ease with working in a paperless environment.
Ability to drive for results
Proven ability to work in a team environment
Ability to resolve conflict in a professional matter
Strong sense of organization and attention to detail
Self-regulation of time management and the ability to multi-task and adhere to deadlines
Familiarity with PIPEDA and how it applies in a confidential patient environment.

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