Job Summary
The Bilingual 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.
Section A : 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
- 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
Section B : General Responsibilities
Adhere to professional standards as prescribed by the professional associations and McKesson as applicableParticipate and assist in departmental continuous improvement activities related to process, quality, trainingParticipate in the development of reports and tools for identifying signals that will flag misunderstanding, misconduct, fraud or other out of protocol program participant related incidentsAssist with reviews of aggregate data to identify program trends and communicate these trends appropriatelyMaintain program data accuracy through review of program documentation for completeness and consistencySupport patients and HCPs with training, education and Injection servicesPerform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, general administrative functions including faxing, filing, scanning.Act as lead point of contact between the program and stakeholdersSection C : Competencies
Knowledge / Education
Licensed RN or RPNUnderstanding and compliance with corporate, divisional, departmental and program-specific standard operating proceduresExperience
1-3 years experience in a previous role with relevant experienceDemonstrated ability to communicate efficiently and in an empathetic manner over the phone and in personExperience in the healthcare industry including, but not limited to medical claims, insurance verification, pharmacy and / or pharmaceutical manufacturers is preferable.Reimbursement experience is an assetMS and Oncology experience is an assetComputer / Application Skills : 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.Problem Solving : 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. Only difficult problems are referred to supervisorExternal Customer Service
Excellent customer service skills in dealing with patients, physicians, and other clientsResolve customer complaintsPlanning / Coordinating Work : Required to initiate planning and coordination of activities with other members in the work group, make appropriate adjustments to one’s own work plansInnovation / Proactivity : Expected to suggest innovations to the supervisor, which affect the job or its workflow. Tries different approaches when initial efforts to solve problems fail; anticipates possible problems and develops alternativesWorking Conditions
Able to work independently and make appropriate decisionsRequired to work rotating shifts (12PM-8PM)Language Skills
Bilingual in English and French required, written and verbal communicationTravel
Up to 5% of travel may be requiredWe 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. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. 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
Our Base Pay Range for this position
49,800 - $83,000