Nurse Case Manager- Ontario
Bayshore HealthCare
Ontario
  • Work from home – Travel required; preference will be given to candidates living in and around Downtown Toronto*
JOB SUMMARY

The Bayshore Specialty Rx Nurse Case Manager will be a single point of contact for program stakeholders; including physicians, nurses, patients and clinics. They will support patients throughout the entire patient support program, from enrollment to injection (including clinical case management services.) The Nurse Case Manager thrives in an environment that emphasizes teamwork, accountability, possesses a deep willingness to serve customers, and drives positive customer experiences in a fast‐paced work environment.

DUTIES AND RESPONSIBILITIES

Provide exemplary courteous and professional service to all program stakeholders
Proactively offer support and advocacy to patients and HCP which includes but is not limited to enrollment, facilitation of coverage renewals, and changes throughout the patient journey, as well as facilitating reimbursement support to physicians
Review patient charts (paper and electronic based) either remotely or in HCP office, or per HCP preference.
Gather all pertinent and appropriate information from the chart to complete the necessary forms (private and/or provincial insurance) in a concise, organized and professional manner
Liaise and advocate with thirdparty providers and provincial governments as necessary to determine coverage options
Followup/advocate until a decision is received, ideally securing coverage for the patient
Provide ongoing support and assistance to ensure patient adherence, as dictated by the needs of the patient
Coordinate patient injection training as required
Liaise with the client Business Unit (Patient Support Manager, Product/Sales Manager, Medical Manager, Territory Manager) as required in order to provide optimal service to HCPs, patients and clinics
Actively establishes and strengthens relationships with HCP within assigned region through agreed upon visits.
Attend meetings with new or existing HCPs based on program necessity
Maintain relevant level of knowledge of GCP (Good Clinical Practice) and Health Canada GVP (Good Pharmocovigilance Practices) guidelines appropriate to their hired role which is to be provided at time of hire and annually. With this knowledge the employee will perform the work as required by their assigned function and will be provided with regular updates as required
Must be able to identify and report AE’s to health Canada, Med Info and enter into source system and third party systems.
Report and document Adverse Events as per training on updated Pharmacovigilance requirements
Participate in ongoing internal and/or external continuing education activities
Adhere to Bayshore Policies and Procedures
Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System as well as key performance indicators for the program
Participate in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns.
Maintain confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel
Complete other tasks as requested

Qualifications:
QUALIFICATIONS

Education

RN in good standing with the College of Nurses.

Registration from an accredited School of Nursing.

Experience

Previous Patient Support Program and Reimbursement experience 3+ years preferred.

Measurable experience with patients suffering with autoimmune and inflammatory disease.

Familiarity with PIPEDA and how it applies in a confidential patient environment.

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.

Other Skills and Abilities

Excellent communication skills

Strong Computer and Technical skills: Excel, Word, Outlook, CRM, web‐portals/internet use

Established internet and home phone access from home office

Ability to travel in and around Downtown Toronto & surrounding areas.

Ability to multi‐task, prioritize, and manage time effectively

Problem‐solving skills, and the ability to think under pressure

Previous experience with customer service principles and practices