Field Case Manager

Cencora • Winnipeg, MB

8d • Hybrid

About The Position

The Field Case Manager plays a crucial role in supporting physicians and patients within specific programs, often related to pharmaceutical initiatives. This position involves customizing program elements to meet physician needs, assisting with patient enrollment and access to coverage, and identifying and resolving obstacles to reimbursement. The role requires building strong relationships with healthcare professionals and their staff, providing training on program details, and acting as a liaison to communicate field observations and feedback to the Program Manager. Additionally, the Field Case Manager is responsible for reporting adverse events, completing various reports, and potentially interacting with patients to provide information on reimbursement, financial assistance, and therapy coordination. The role may also involve mentoring new team members, collaborating with pharmaceutical teams, and attending educational events. This position requires significant travel within an assigned territory, including potential overnight stays, and necessitates reliable transportation and a valid driver's license. The company is committed to fair and accessible employment practices, including providing accommodations for individuals with disabilities during the recruitment and hiring process.

Requirements

• A Bachelor’s degree in health care or a related discipline.
• Minimum of five (5) years, in the healthcare, pharmaceutical or insurance industry or related experience.
• NURSING LICENSE IS MANDATORY
• Available to travel within an assigned territory, some overnight travel may be required.
• Valid Driver’s License, current auto insurance policy and access to reliable transportation, for regional travel.
• Knowledge of private and public reimbursement structure, systems, and process.
• Experience with reimbursement navigation, special authorization, appeals process and conducting field-based reimbursement support and consultation.
• Strong analytical skills including interpretation of regulation and legislation.
• Fluency in French and/or English may be required depending on program and geographic location.

Nice To Haves

• Experience and background in various therapeutic areas is an asset.
• Background in business administration (pharmaceutical) sales and marketing an asset.

Responsibilities

• Customizes program elements to meet the needs of assigned prescribing physicians.
• Reviews patient status and assists the prescribing physician to complete patient enrolment, prepare payer forms to access public or private coverage by reviewing patient charts, documenting previous therapies and tests in order to complete the payer forms.
• Proactively assesses programs and makes suggestions to enhance outcomes and quality of service.
• Identifies obstacles to obtaining coverage and channels this information to the Program Manager.
• Develops strong working relationships with physicians and physician office staff, providing additional office support to ensure smooth maintenance of patients enrolled in the program as needed.
• Proactively provides assistance to resolve issues with regards to assigned physicians.
• Provides training to physicians and clinics on program and new initiatives approved by the manufacturer.
• Acts a liaison and provides ongoing feedback to the Program Manager based on observations in the field and feedback from physicians as it pertains to quality of services, training, and other areas of importance.
• Reports Adverse Events / Severe Adverse Events following program Standard Operating Procedures.
• Completes all relevant reports (program specific reports, expenses, etc.) as per specified timelines and as per required standards.
• Welcomes each patient to the program and captures required patient information.
• Provides reimbursement payer guidelines to patients and physicians.
• Ensures patient services are coordinated and tracked, according to KPI’s, resulting in expedited access to therapy.
• Coordinates private and public coverage activity directly with insurers following program Standard Operating Procedures.
• Follow up with patient the outcome of reimbursement navigation.
• Provide information and navigate patient through financial assistance.
• Assist patient with pharmacy selection and coordinate drug delivery.
• Assist patient with coordination of therapy and ongoing therapy status.
• Refer the patient to contact their healthcare provider should the patient have clinical questions, assessments and situations that fall outside program provided materials or manufacturer product monograph.
• Assists in training and development of new Field Drug Access Navigator as needed.
• Supports and assists peers through regular and ongoing communication.
• Develops and maintains a positive relationship with the Patient Support Program team.
• Provides timely patient and clinic information as needed, through specific means used by the program.
• Participates in scheduled physician meetings with Pharmaceutical team.
• Attends scheduled Continuous Medical Education events and reports new activities.
• Provides in service presentation to physicians in collaboration with the Pharmaceutical Representatives on new program initiatives.
• Ongoing maintenance of communication with Program Manager, physicians, physician office staff, client representatives, patients and nursing team as required.
• Completes all relevant reports (time sheets, expenses, mileage, reports etc.) as per specified timelines and as per required standards.
• May be required to be on standby/ on call as part of this role.

Benefits

• Cencora is committed to fair and accessible employment practices. When requested, Cencora will accommodate people with disabilities during the recruitment, assessment and hiring processes and during employment.
• Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.
• Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level