Bilingual Field Clinical Case Manager

3 weeks ago

Montréal, Canada Bayshore HealthCare Full time

**ABOUT THE ROLE**:
The Bilingual Field Nurse Case Manager (FNCM) will play an essential role in supporting patients living with a respiratory
disease to improve both their health outcomes and quality of life. Offer enrolment and reimbursement support to
physicians and medical case management services to patients. Assist the physician with the completion of all programspecific paperwork. 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 provide continuous support for renewals and coverage
changes.

**A DAY IN THE LIFE**
- Assist the prescribing physician to complete patient enrolment; including on-site visits to the physician’s office to
gather all pertinent and 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
- Review patient charts in physician office (paper and electronic based); keep electronic charts
- Ensure patients are scheduled for blood work and notify physicians of expired blood work results
- Complete Welcome Call activities with the patient according to defined scripts
- Facilitate any required communication with physicians, Patient Support Programs, or other health care professionals
involved in the patient’s circle of care
- Follow up/advocate until a decision is received, ideally securing coverage for the patient
- Work closely with the manufacturer local sales representatives to support specific physician’s and staff needs
- 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
- Provide updates to stakeholders based on observations, including those gathered in the field (physicians’ offices)
- Ensure patient records are maintained and data-accurate to meet program reporting requirements
- Must be able to identify and report Adverse Events 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
- Maintain confidentiality of client and corporate information and discuss same only with appropriate Bayshore personnel
- Travel to physicians’ offices on a regular basis as requested by those offices
- Complete all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore’s
policy
- Complete product complaint reports Adhere to Bayshore and manufacturer Policies and Procedures Job Qualification

**What You Bring to the Team**:

- Registered Nurse or Registered Practical Nurse (RN/RPN) license
- Bilingual in French and English
- Registered and in good standing with the College of Nurses
- Minimum 2 years’ experience in Patient Support Programs
- Providing excellent customer service skills internally as well as externally
- Excellent verbal and written communication skills and interpersonal skills; English and French if servicing Quebec or New
Brunswick
- Reimbursement experience
- 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
- 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
- Valid driver’s license with less than 2 infractions in the past 2 years

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