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Field Case Manager
2 weeks ago
**Lieu**:
5990 Henri-Bourassa West, Montreal, Québec, H4R 3A6
Chez Shoppers Drug Mart/Pharmaprix, nous innovons en matière de santé et de bien-être au Canada. Des ordonnances aux cliniques sans rendez-vous, en passant par un programme de fidélisation des plus appréciés, nous prenons soin de nos clients et les soutenons grâce à des nouvelles approches tous les jours.
Avec plus de 1 300 magasins détenus et exploités localement d’un océan à l’autre, le réseau de Shoppers Drug Mart/Pharmaprix est un milieu de travail et de magasinage formidable. Nous sommes déterminés à bâtir une équipe talentueuse prônant la collaboration, la générosité et l’inclusion. Joignez-vous à notre équipe et contribuez à créer un avenir sain pour votre carrière et pour tous les Canadiens.
**Pourquoi ce role est-il important?**
**Nurse Field Case Manager (FCM) - Québec**
**Why work at Specialty Health Network?**
Specialty Health Network (or SHN, as we call ourselves) is a growing division of Shoppers Drug Mart, with a strong entrepreneurial spirit. We pride ourselves in having an awesome work culture and fun environment We offer competitive salaries, a great benefit package, Shoppers Drug Mart discount, Goodlife gym discount, RRSP/Pension plans, Employee share ownership plan, professional training and development and many more perks
Shoppers Drug Mart was acquired by Loblaw in 2014, the largest employer in Canada - making your career opportunities within our larger organization - endless
**Why is this position 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 the patient/physician/client through flawless customer service. The Nurse Field Case Manager will deliver, through expert communication skills and available resources, quality and cost-effective treatment outcomes for the patient. The Nurse Field Case Manager will work directly with the reimbursement team to help secure drug coverage. They will support physicians in managing all aspects related to facilitating patient access to therapy and will provide service in person or remotely according to customer preference.
The Nurse Field Case Manager will help support a busy caseload in their respective territory, building strong working relationships, collaboration, effective communication and attention to detail both internally and externally to meet specific team and business objectives. In addition, the Nurse Field Case Manager will attend training sessions, complete self-learning assignments and independent studies while adhering to SDM Specialty Health Network Standard Operating Procedures, Policies, and the College of Nurses Standards of Practice.
**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 prepares documentation in support of reimbursement requests
- Determine patients’ channels and eligibility for reimbursement and provides assistance at all levels
- Review patient status and assists the prescribing physician to populate Special Authorization forms (SA) for public or private coverage by reviewing patient charts, assessing previous therapies and test results in order 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 provides 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
- Management of 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 as it pertains to quality of services, training, and other areas of importance. Feedback and observations are channeled to the manufacturer as appropriate.
- Collaborate with sales reps and as
