The Field Nurse Case Manager (FNCM) will play an essential role in the patient’s treatment journey, by optimizing and accelerating positive outcomes for internal and external stakeholders FNCM 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.
DUTIES AND RESPONSIBILITIES
• Assist the prescribing physician to complete patient enrolment; including on-site visits to the physician’s office to gather all pertinent and appropriate information to complete the necessary forms (private and/or provincial insurance) in a concise, organized, and professional manner
• Proactively offers support and advocacy to patients and HCP
• Visits prescribers in their assigned area to assist with paperwork in office as required
• Review patient charts to gather all pertinent and appropriate information to complete necessary reimbursement forms in a concise, organized and professional manner
• Actively establish and strengthen relationships with HCP within assigned region through on site and virtual visits
• Accountable for conducting physician site visits across diverse geographical territories
• 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/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
EDUCATION
• Graduate of Registered Nursing Program or Registered/Licensed Practical Nursing program holding current registration from a provincial licensing body in Canada
EXPERIENCE
• Registered and in good standing with their provincial regulatory body
• Minimum 2 years’ experience in Patient Support Programs or equivalent
• 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)
• Strong computer and technical skills: Excel, Word, Outlook, tablets, web portals/internet use
• Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset
• Strong critical thinking and problem-solving skills
• Accurate data collection and integrity
• Ease with working in a paperless environment
• Proven ability to work in a team environment
• Ability to resolve conflict in a professional manner
• 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
• Possession of a valid driver's license, with the capability and willingness to travel extensively across assigned territories, utilizing reliable personal transportation
OTHER SKILLS & ABILITIES
• These will be program specific
• Ex. Oncology experience or etc
Bayshore is committed to a high quality and safe environment for both our staff and clients/patients. Dependent upon Provincial government regulations, and the position being applied for, new hires may be required to provide proof of vaccination against illnesses such as COVID-19, Hepatitis, Seasonal Flu etc. Please speak with the recruiter for Provincial and/or position specific requirements. Medical exemptions or any based upon Human Rights Code criteria will be considered on a case-by-case basis.
“At Bayshore Healthcare, our commitment to Equity, Diversity & Inclusion is our strength. This is how we bring our vision of being the difference in the lives of those we care for, work with and in our communities. We have a great sense of pride in creating a culture of belonging, where individual differences are embraced and celebrated, through programs, resources and policies that support each individuals purpose, potential and wellbeing.”
At Bayshore Healthcare Ltd., and its subsidiaries, we are committed to fostering an inclusive workplace and operate in full compliance with all Provincial and Territorial legislation pertaining to Human Rights Codes and Accessibility requirements. To ensure continued compliance throughout the recruitment and selection process, we encourage candidates to disclose any accommodation needs they may have.
