Infirmière gestionnaire de cas sur le terrain (FCM) - Contrat 20 mois -- Field Case Manager - Quebec City, QC (20 month contract)

Shoppers Drug Mart•Montreal, QC

4d•CA$80,000 - CA$110,000•Hybrid

About The Position

At Shoppers Drug Mart, we are innovating health and wellness in Canada. We offer a variety of services including prescriptions, walk-in clinics, and a loyalty program, all aimed at caring for and supporting our customers in new ways every day. With over 1,300 locally owned and operated stores across Canada, the Shoppers Drug Mart network is a great place to shop and an even better place to work. We are dedicated to building a talented team that embodies collaboration, kindness, and inclusivity. Join us and contribute to a healthy future for your career and for all Canadians. Specialty Health Network (SHN) is a rapidly growing division of Shoppers Drug Mart, characterized by a strong entrepreneurial spirit. We are proud of our exceptional work culture and enjoyable environment. We provide competitive salaries, a comprehensive benefits package, Shoppers Drug Mart discounts, Goodlife gym discounts, RRSP/Pension plans, an employee share ownership plan, professional training and development, and numerous other perks. Shoppers Drug Mart became part of Loblaw in 2014, Canada's largest employer, offering endless career opportunities within our larger organization.

Requirements

Registered Nurse with a current, unrestricted license in the province of employment.
Proficient in reimbursement landscape and completion of Special Authorization and Appeal Letters.
Demonstrated customer/account focus and consistently deliver on the PSP value proposition.
Five or more years direct clinical experience.
Strong communication and telephony skills.
Demonstrated leadership experience and ability to work under pressure.
Ability to provide an organized, efficient approach to case management.
Possession of excellent skills in assessment, communication, critical thinking and decision making.
Ability to demonstrate understanding of SDM Specialty Health Network policies, legal considerations and professional ethics.
Proficiency of computer skills including, Microsoft 365.
Ability to adapt to a changing environment.
Commitment to the principle of quality client-centered service delivery.
Travel required up to 60% in territory (some overnight may be required).
Valid driver’s license and with reliable vehicle.

Nice To Haves

BScN preferred, however, a combination of experience and education will be considered.
Recent experience with Patient Support Programs (PSP) an asset.
Fluently bilingual in both written and spoken languages is an asset (French & English).

Responsibilities

Responsible for a collaborative process of ongoing assessment, planning, facilitation, service coordination, evaluation, and advocacy to meet patient/physician/client needs through flawless customer service.
Deliver quality and cost-effective treatment outcomes for the patient through expert communication skills and available resources.
Work directly with the reimbursement team to help secure drug coverage.
Support physicians in managing all aspects related to facilitating patient access to therapy.
Provide service in person or remotely according to customer preference.
Support a busy caseload in their respective territory, building strong working relationships, collaboration, effective communication, and attention to detail both internally and externally to meet specific team and business objectives.
Attend training sessions, complete self-learning assignments, and independent studies while adhering to SDM Specialty Health Network Standard Operating Procedures, Policies, and the College of Nurses Standards of Practice.
Assist the health care practitioner (HCP) in completing the Program enrollment form, as applicable.
Educate the HCP on the Program enrollment requirements.
Gather patient Program enrollment required information (physician signature, patient contact information, and product information).
Provide reimbursement assistance to patients and physicians according to need.
Provide physicians with payer documentation support.
Investigate case-by-case reimbursement options, channels, procedures, and prepares documentation in support of reimbursement requests.
Determine patients’ channels and eligibility for reimbursement and provides assistance at all levels.
Review patient status and assists the prescribing physician to populate Special Authorization forms (SA) for public or private coverage by reviewing patient charts, assessing previous therapies and test results in order to complete the SA.
Ensure the coordination and follow-up of SA submissions with payers.
Support treating physician in the development of appeal letters, as required.
Act as a resource for treating physicians and provides guidance regarding payer reimbursement criteria.
Assist patients and physicians with the annual prescription renewal process.
Assist patients and physicians with the SA renewal process (most commonly annually), as applicable.
Identify obstacles and delays to obtaining coverage, take appropriate action and identify alternative channels for patient coverage.
Manage patient files in the program database.
Educate the HCP and patients regarding Program services by providing general Program and Product information based on SOPs, Product Monograph, approved verbatim and other approved materials.
Review and discuss comprehensive program components, services, and value-add program offerings.
Act as a liaison and provide ongoing feedback to manufacturers based on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance.
Collaborate with sales reps and associates according to guidance and guidelines.
Attend scheduled educational events as required.
Report Adverse Events /Severe Adverse Events (AE/SAEs) in accordance with established agreements.
Maintain high standards of professional practice by adhering to the ethics of the profession and keeping abreast of the latest professional advancements.
Assume responsibility for personal and professional learning and development.
Other responsibilities as required by SDMSHN.