Nurse Case Manager

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Job Summary

The Nurse Case Manager is an integral part of the Patient Services team, responsible for the coordination and delivery of services related to the patient support programs offered by McKesson Specialty. The role involves interactions with patients, insurance companies, pharmacies, physicians and other health care professionals (HCPs) and provide support to their patients. The role involves understanding, adherence to corporate, divisional, departmental, and program specific standard operating procedures.

This role is a full-time, permanent position with rotating evening shift (12pm-8pm) availability required.

Travel: Up to 5% of travel to clinics across Ontario may be required.

Specific Responsibilities

• The Nurse Case Manager is the point of contact for the program, doctors, pharmacies and other HCP’s.

• May be required to provide training and educational materials to patients pertaining to their medication and conduct adherence follow ups.

• Review, analyze and validate information provided by patients and HCPs for accuracy and completeness to ensure initiation of services.

• Follow the program protocols to ensure that the most appropriate next step is scheduled to ensure continuity of service delivery to HCPs and patients.

• Complete follow ups with patients on behalf of the physician offices, as required, to ensure adherence to treatment regimens:

  • Liaise with the patient, insurer and physician regarding the documentation required for maximum reimbursement coverage, including the exploration of all public and private insurers and providing employer escalations as required.

  • Relationship building with key clinics

• Process data entry activities of pertinent information received at different points of contact during the delivery of program services.

• Provide answers to general inquiry calls submitted via telephone, web-based platforms or in person, on program services, disease state or product related questions, based on information provided as part of the program materials.

• Provide HCP and Patients with a technical product overview when required.

• Liaise with physicians’ offices, services providers and other parties to provide comprehensive and coordinated service to patients and physicians.

• Receive, record and report Adverse Events, as per program working instructions.

• Maintain service levels in case management, including Adverse Events reported within twenty-four hours of receipt and any other Key Performance Indicators established at the Program level.

• Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, general administrative functions including faxing, filing, scanning.

• Other duties as assigned.

General Responsibilities

• Participate and assist in departmental continuous improvement activities related to process, quality, training.

• Participate in the development of reports and tools for identifying signals that will flag misunderstanding, misconduct, fraud or other out of protocol program participant related incidents.

• Assist with reviews of aggregate data to identify program trends and communicate these trends appropriately.

• Maintain program data accuracy through review of program documentation for completeness and consistency.

• Support patients and HCPs with training, education and Injection services.

• Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, general administrative functions including faxing, filing, and scanning.

• Act as lead point of contact between the program and stakeholders.

Minimum Qualifications

• Minimum 2 years of relevant experience.

• Must be an RN, RPN, or NP with the College of Nurses of Ontario, Canada. Must be a member in good standing.

Key Competencies

• Bilingualism (French/English) is an asset.

• Understanding and compliance with corporate, divisional, departmental and program specific standard operating procedures.

• Demonstrated ability to communicate efficiently and in an empathetic manner over the phone and in person.

• Experience in the healthcare industry including, but not limited to medical claims, insurance verification, pharmacy and/or pharmaceutical manufacturers is preferable.

• Required to use menu-driven retrieval and search functions on Windows based applications, web-based applications and proprietary information technology systems; ability to use a switch-based telephony software, etc.

• Navigates quickly and effectively to resolve problems and obstacles, even when complex and unique circumstances occur; responds to recurring problems by investigating the underlying causes and taking steps to eliminate them.

• Excellent customer service skills in dealing with patients, physicians, and other clients.

• Able to work independently and make appropriate decisions.

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

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McKesson job postings are posted on our career site: careers.mckesson.com.

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

McKesson welcomes and encourages applications from people with disabilities. Accommodations are available on request for candidates taking part in all aspects of the selection process. If you require accommodation please contact us by sending an email to Disability_Accommodation@McKesson.com.

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