About the role
Job Summary 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 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
- Liaise and advocate with third-party providers and provincial governments as necessary to determine coverage options.
- Review patient charts in physician office (paper and electronic based); keep electronic charts.
- 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 healthcare 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 andstaff 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, patientsand clients.
- Provide updates to stakeholders based on observations in the field and physicians.
- Ensure patient records are maintained and data accurate to meet program reporting requirements.
- Must be able to identify and report AE’s to health Canada, Med Info and enter into source systemand third-party systems.
- Report and document Adverse Events as per Pharmacovigilance requirements.
- Participate in quality activities and continuous improvement initiatives in keeping with thecompany’s Quality Management System as well as specific performance indicators for the project.
- Maintains confidentiality of client and corporate information and discusses same only withappropriate Bayshore personnel.
- Requires traveling to physician’s offices on a regular basis as requested by the physician’s office.
- Completes all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore’s policy.
- Complete product complaint reports.
- Adhere to Bayshore and manufacturer policies and procedures.
- Complete other tasks as requested.
Qualifications
- Registered Nurse or Registered Practical Nurse (RN/RPN) license.
- Preference with candidate that have experience with the product.
- Registered and in good standing with the College of Nurses.
- Minimum 2 years’ experience in Patient Support Programs.
- Providing excellent customer services skills internally as well as externally.
- Excellent verbal and written communication skills and interpersonal skills; English and Bilingual is servicing Quebec.
- Reimbursement experience
- Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.
- Familiarity with the Special Authorization process for both public and private insurance in assigned territory.
- Strong computer and technical skills: Excel, Word, Outlook, tablets, web-portals/internet use.
- Strong critical thinking and problem-solving skills.
- Making decisions using sound judgement, and meeting deadlines.
- Accurate data collection and data integrity.
- Ease with working in a paperless environment.
- Ability to drive for results.
- Proven ability to work in a team environment.
- Ability to resolve conflict in a professional matter.
- 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.
- Valid driver’s license with less than 2 infractions in the past 2 years.
Primary Location British Columbia
About Bayshore HealthCare
At Bayshore, we believe in creating special moments for our clients each and every day, whether at the bedside, on the phone or in the clinic. These moments touch the lives of our clients and our employees, and they guide the way we run our business. These moments inspire, change and encourage us. They are what we call the Bayshore difference.
Bayshore HealthCare is one of the country’s leading providers of home and community health care services and is a Canadian-owned company.
With over 100 locations across the country, including home care offices, pharmacies and infusion clinics, Bayshore has more than 13,000 staff members and provides care to over 350,000 clients. We are dedicated to enhancing the quality of life, dignity and independence of all Canadians, by providing customized care plans and solutions that allow clients to remain in the comfort of their own home. See what some of our clients have to say about their experience with Bayshore. We have been a recipient of Canada’s Best Managed Companies award since 2006.
Chez Bayshore, nous croyons en la création de moments spéciaux pour nos clients, chaque jour, que ce soit à leur chevet, au téléphone ou dans une clinique. Nous cherchons à améliorer la qualité de vie, la dignité et l’autonomie de tous les Canadiens, en fournissant des plans de soins personnalisés et des solutions qui permettent à nos clients de rester dans le confort de leur propre foyer.
Bayshore, une entreprise exclusivement canadienne, est l’un des plus importants fournisseurs de services de santé à domicile et en milieu communautaire au Canada. Avec plus de 100 établissements à travers le pays, y compris des succursales dédiées à la prestation de soins à domicile, des pharmacies et des cliniques de perfusion, Bayshore compte au-delà de 13 000 employés et prodigue des soins à plus de 350 000 clients.
AP-2000672
About the role
Job Summary 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 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
- Liaise and advocate with third-party providers and provincial governments as necessary to determine coverage options.
- Review patient charts in physician office (paper and electronic based); keep electronic charts.
- 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 healthcare 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 andstaff 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, patientsand clients.
- Provide updates to stakeholders based on observations in the field and physicians.
- Ensure patient records are maintained and data accurate to meet program reporting requirements.
- Must be able to identify and report AE’s to health Canada, Med Info and enter into source systemand third-party systems.
- Report and document Adverse Events as per Pharmacovigilance requirements.
- Participate in quality activities and continuous improvement initiatives in keeping with thecompany’s Quality Management System as well as specific performance indicators for the project.
- Maintains confidentiality of client and corporate information and discusses same only withappropriate Bayshore personnel.
- Requires traveling to physician’s offices on a regular basis as requested by the physician’s office.
- Completes all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore’s policy.
- Complete product complaint reports.
- Adhere to Bayshore and manufacturer policies and procedures.
- Complete other tasks as requested.
Qualifications
- Registered Nurse or Registered Practical Nurse (RN/RPN) license.
- Preference with candidate that have experience with the product.
- Registered and in good standing with the College of Nurses.
- Minimum 2 years’ experience in Patient Support Programs.
- Providing excellent customer services skills internally as well as externally.
- Excellent verbal and written communication skills and interpersonal skills; English and Bilingual is servicing Quebec.
- Reimbursement experience
- Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.
- Familiarity with the Special Authorization process for both public and private insurance in assigned territory.
- Strong computer and technical skills: Excel, Word, Outlook, tablets, web-portals/internet use.
- Strong critical thinking and problem-solving skills.
- Making decisions using sound judgement, and meeting deadlines.
- Accurate data collection and data integrity.
- Ease with working in a paperless environment.
- Ability to drive for results.
- Proven ability to work in a team environment.
- Ability to resolve conflict in a professional matter.
- 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.
- Valid driver’s license with less than 2 infractions in the past 2 years.
Primary Location British Columbia
About Bayshore HealthCare
At Bayshore, we believe in creating special moments for our clients each and every day, whether at the bedside, on the phone or in the clinic. These moments touch the lives of our clients and our employees, and they guide the way we run our business. These moments inspire, change and encourage us. They are what we call the Bayshore difference.
Bayshore HealthCare is one of the country’s leading providers of home and community health care services and is a Canadian-owned company.
With over 100 locations across the country, including home care offices, pharmacies and infusion clinics, Bayshore has more than 13,000 staff members and provides care to over 350,000 clients. We are dedicated to enhancing the quality of life, dignity and independence of all Canadians, by providing customized care plans and solutions that allow clients to remain in the comfort of their own home. See what some of our clients have to say about their experience with Bayshore. We have been a recipient of Canada’s Best Managed Companies award since 2006.
Chez Bayshore, nous croyons en la création de moments spéciaux pour nos clients, chaque jour, que ce soit à leur chevet, au téléphone ou dans une clinique. Nous cherchons à améliorer la qualité de vie, la dignité et l’autonomie de tous les Canadiens, en fournissant des plans de soins personnalisés et des solutions qui permettent à nos clients de rester dans le confort de leur propre foyer.
Bayshore, une entreprise exclusivement canadienne, est l’un des plus importants fournisseurs de services de santé à domicile et en milieu communautaire au Canada. Avec plus de 100 établissements à travers le pays, y compris des succursales dédiées à la prestation de soins à domicile, des pharmacies et des cliniques de perfusion, Bayshore compte au-delà de 13 000 employés et prodigue des soins à plus de 350 000 clients.
AP-2000672