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Bilingual Nurse Case Manager
1 month ago
About the Role
The Nurse Case Manager (NCM) is a single point of contact offering support to physicians and medical case management services to patients. Assist the physician with the completion of all program-specific paperwork and follow-up on submissions pertaining to obtaining drug access through various means to ensure patients have access to their prescribed treatments in a timely manner. Act as a resource to physicians who are prescribing this medication and continuous support for patients via phone for renewals, and coverage changes.
This role is operated on a remote basis and is open to candidates that reside in various provinces and territories in Canada.
A Day in the Life
- Assist 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 manner
- Liaise and advocate with third-party providers and provincial governments as necessary to determine coverage options
- Ensure patients are scheduled for necessary diagnostic tests and notify physicians of any expired test results that require follow-ups
- Complete Welcome Call activities with the patient according to defined scripts
- Provide patients and physicians with direct toll-free number
- Review post visit reports to confirm next appointment is scheduled and data integrity of the report against the physician order, if applicable
- Track missing post visit reports, if applicable
- Facilitate any required communication with physicians, Patient Support Programs, or other health care professionals involved in the patient's circle of care
- Follow up and advocate until a decision is received, ideally securing coverage for the patient, if applicable
- Work closely with the manufacturer local sales representatives to support specific physician's and staff needs, if applicable
- Offer and/or provide educational training to patients and physicians on product(s)
- Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics
- Coordinate and schedule patients at appropriate visit locations (home, clinic, etc.)
- Provide updates to internal and external stakeholders based on observations
- 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 pharmaceutical partner(s) and corporate information and discuss same only with appropriate Bayshore personnel
- Complete all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore's policy, if applicable
- 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
- Graduate of Registered Nursing Program or Registered/Licensed Practical Nursing program holding current registration from a provincial licensing body in Canada.
- Registered and in good standing with their provincial regulatory body
- Minimum 2 years' experience in Patient Support Programs or equivalent
- Minimum 1 year of Canadian public and private reimbursement navigation and advocacy experience, within a patient program environment is an asset
- Oncology experience is considered a valuable asset
- Demonstrated expertise in delivering exceptional customer service and fostering positive relationships with internal and external stakeholders
- Must be fluent in verbal and written communication and interpersonal skills for both English and French (Applicable for provinces/regions with French language service requirements)
- Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset
- 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
- Proficient with 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
- Ability to work in a quiet working environment with proven ability to work autonomously within a remote/virtual team environment
- Established high speed internet access from home office
