Nurse Case Manager

Job Description

JOB SUMMARY

Nurse Case Manager (NCM) will play an essential role in supporting patients living with a dermatological disease to improve both their health outcomes and quality of life. NCM offers enrolment and reimbursement 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 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 continuous support for renewals, and coverage changes.

The Nurse Case Manager role will be a 12-month contract.

DUTIES AND RESPONSIBILITIES

• Liaise and advocate with third-party providers and provincial governments as necessary to determine coverage options.
• 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 Assistant Programs or other health care professionals involved in the patients’ 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.

Job Qualification

QUALIFICATIONS

Experience

o Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.

o Familiarity with the Special Authorization process for both public and private insurance in assigned territory.