Nurse Case Manager

About the RoleThe Nurse Case Manager (NCM) will play an essential role in supporting patients living with a respiratory disease to improve both their health outcomes and quality of life.

Complete enrolment calls, respond to patient inquiries and offer reimbursement support to physicians and medical case management services to patients.

Assist the Field Nurse Case Manager with the completion of all program-specific paperwork including Special Authorizations, appeals, prescription renewals, and medical clarifications.

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.

The Nurse Case Manager will support with scheduling patients and reviewing Post Injection Reports to ensure adequate injection and / or training is completed.

Submit Adverse Events as required by Health Canada.This is a fully remote position that reports under Bayshore Specialty RX located at Mississauga, ON.

As a Nurse Case Manager, you will be able to work from anywhere in Canada, including the following provinces : Ontario, Quebec, British Columbia, Alberta, Manitoba, Saskatchewan, Nova Scotia, New Brunswick, Newfoundland and Labrador, and Prince Edward Island.

A Day in the LifeAssist the Field Nurse Case Manager to complete 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 mannerLiaise and advocate with third-party providers and provincial governments as necessary to determine coverage optionsReview patient charts (paper and electronic based);

keep electronic chartsEnsure patients are scheduled for blood work and notify physicians of expired blood work resultsComplete Welcome Call activities with the patient according to defined scriptsReview Post Injection Reports to confirm next appointment is scheduled and data integrity of the report against the physician orderTrack missing Post Injection ReportsFacilitate any required communication with physicians, Patient Support Programs, or other health care professionals involved in the patient’s circle of careFollow up / advocate until a decision is received, ideally securing coverage for the patientWork closely with the manufacturer local sales representatives to support specific physician’s and staff needsOffer and / or provide educational training to patients and physicians on product’s administrationAct as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinicsCoordinate and schedule patients at appropriate injection locations (home, clinic, etc.

Provide updates to stakeholders based on observationsEnsure patient records are maintained and data-accurate to meet program reporting requirementsMust be able to identify and report Adverse Events to Health Canada, Med Info, and enter into source system and third-party systemsReport and document Adverse Events as per Pharmacovigilance requirementsParticipate in quality activities and continuous improvement initiatives in keeping with the company’s Quality Management System as well as specific performance indicators for the projectMaintain confidentiality of client and corporate information and discuss same only with appropriate Bayshore personnelComplete all relevant reports (time sheets, expenses, mileage, reports, etc.

as per specified timelines and Bayshore’s policyComplete product complaint reportsAdhere to Bayshore and manufacturer Policies and ProceduresComplete other tasks, as requestedJob QualificationWhat You Bring to the TeamRegistered Nurse or Registered Practical Nurse (RN / RPN) licensePreference with candidate that has experience with the productRegistered and in good standing with the College of NursesMinimum 2 years’ experience in Patient Support ProgramsProviding excellent customer service skills internally as well as externallyExcellent verbal and written communication skills and interpersonal skills;

English and French if servicing Quebec and New BrunswickReimbursement experienceUnderstanding of provincial and private coverage criteria and how to navigate the Canadian drug coverage landscapeFamiliarity with the Special Authorization process for both public and private insurance in assigned territoryStrong computer and technical skills : Excel, Word, Outlook, tablets, web portals / internet useStrong critical thinking and problem-solving skillsMaking decisions using sound judgmentAccurate data collection and data integrityEase with working in a paperless environmentAbility to drive for resultsProven ability to work in a team environmentAbility to resolve conflict in a professional matterStrong sense of organization and attention to detailSelf-regulation of time management and the ability to multi-task and adhere to deadlinesFamiliarity with PIPEDA and how it applies in a confidential patient environment