About the Role
The Nurse Case Manager (NCM) that is referred to as Clinical Case Manager in this program is single a 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 Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, Quebec, Saskatchewan, Northwest Territories, Nunavut, and Yukon.
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.), if applicable
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