Field Case Manager-3

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. With more than 1,300 locally owned and operated stores across the country, our network is a great place to work and a great place to shop. We’re committed to building a talented team that champions collaboration, kindness and inclusivity. Join our team and help shape a healthy future for your career and for all Canadians. Nurse Field Case Manager (FCM) – Ontario Shoppers Drug Mart – Specialty Health Network (SHN) Why this role is important The Nurse Field Case Manager (FCM) is responsible for a collaborative process of ongoing assessment, planning, facilitation, service coordination, evaluation and advocacy to meet the needs of patients, physicians and clients through flawless customer service. The FCM delivers quality, cost‑effective treatment outcomes for the patient and works directly with the reimbursement team to secure drug coverage. The FCM supports physicians in managing all aspects related to facilitating patient access to therapy and provides service in person or remotely according to customer preference. What you will do Assist the health care practitioner (HCP) in completing the Program enrolment form, as applicable Educate the HCP on the Program enrolment requirements Gather patient Program enrolment required information (physician signature, patient contact information, and product information) Provide reimbursement assistance to patients and physicians according to need Provide physicians with payer documentation support Investigate case‑by‑case reimbursement options, channels, procedures, and prepare documentation in support of reimbursement requests Determine patients’ channels and eligibility for reimbursement and provide assistance at all levels Review patient status and assist the prescribing physician to populate Special Authorization forms (SA) for public or private coverage by reviewing patient charts, assessing previous therapies and test results to complete the SA. The above may be done on site or remotely, as required Ensure the coordination and follow up of SA submissions with payers Support treating physician in the development of appeal letters, as required Act as a resource for treating physicians and provide guidance regarding payer reimbursement criteria Assist patients and physicians with the annual prescription renewal process Assist patients and physicians with the SA renewal process (most commonly annually), as applicable Identify obstacles and delays to obtaining coverage, take appropriate action and identify alternative channels for patient coverage Manage patient files in the program database Educate the HCP and patients regarding Program services by providing general Program and Product information based on SOPs, Product Monograph, approved verbatim and other approved materials Review and discuss comprehensive program components, services and value‑add program offerings Act as a liaison and provide ongoing feedback to manufacturer based on observations in the field and feedback from customers regarding quality of services, training and other areas of importance. Feedback and observations are channeled to the manufacturer as appropriate Collaborate with sales reps and associates according to guidance and guidelines Attend scheduled educational events as required Report Adverse Events / Severe Adverse Events (AE/SAEs) in accordance with established agreements Maintain high standards of professional practice by adhering to the ethics of the profession and keeping abreast of the latest professional advancements Assume responsibility for personal and professional learning and development Other responsibilities as required by SDMSHN What you will need Registered Nurse with a current, unrestricted license in the province of employment BScN preferred, however, a combination of experience and education will be considered Proficient in reimbursement landscape and completion of Special Authorization and Appeal Letters Recent experience with Patient Support Programs (PSP) an asset Demonstrated customer/account focus and consistently deliver on the PSP value proposition Fluently bilingual in both written and spoken languages is an asset (French & English) Five or more years direct clinical experience Strong communication and telephony skills Demonstrated leadership experience and ability to work under pressure Ability to provide an organized, efficient approach to case management Possession of excellent skills in assessment, communication, critical thinking and decision making Ability to demonstrate understanding of SDM Specialty Health Network policies, legal considerations and professional ethics Proficiency of computer skills including Microsoft 365 Ability to adapt to a changing environment Commitment to the principle of quality client‑centered service delivery Valid driver’s license and reliable vehicle Employment Type Full time Type of Role Regular Diversity & Inclusion Shoppers Drug Mart views diversity in Canada as a national pride and strength. Our priority is to reflect the growing diversity of our country through the people we hire, our corporate culture and our products. Accommodations are available upon request for people living with disabilities during the recruitment, assessment and post‑employment process. We are committed to complying with the law. Compliance with laws is part of our Code of Conduct, which outlines the expectations of our customers and stakeholders. #J-18808-Ljbffr