Field Case Manager

Cencora • Winnipeg, MB

11d • Onsite

About The Position

At Cencora, team members are essential to creating healthier futures. This Field Case Manager role, also referred to as a Field Drug Access Navigator, is central to improving lives by connecting manufacturers, providers, and patients. The position involves customizing program elements for prescribing physicians, assisting with patient enrollment, and preparing payer forms to secure public or private coverage. Key responsibilities include proactively assessing programs for quality improvement, identifying coverage obstacles, and fostering strong relationships with physicians and their staff. The role also entails providing training on new program initiatives and acting as a liaison to the Program Manager, offering field observations and feedback. Patient support is a critical component, involving welcoming patients, providing reimbursement guidelines, coordinating services to expedite therapy access, navigating financial assistance, and coordinating drug delivery and ongoing therapy status. The Field Case Manager will also assist in training new navigators, support peers, maintain positive relationships within the Patient Support Program team, and provide timely patient and clinic information. Manufacturer interface includes participating in physician meetings and Continuous Medical Education events, and presenting new program initiatives in collaboration with Pharmaceutical Representatives. Ongoing communication with various stakeholders and comprehensive reporting are also required. This is a full-time position based in the Winnipeg, MB region, requiring travel within an assigned territory, potentially including overnight stays, and may involve being on standby/on call.

Requirements

• A Bachelor’s degree in health care or a related discipline
• Requires a 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
• Will also be assigned other duties and tasks as required from time to time

Benefits

• Compensation
• Medical care
• Dental care
• Vision care
• Comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness
• Support for working families
• Backup dependent care
• Adoption assistance
• Infertility coverage
• Family building support
• Behavioral health solutions
• Paid parental leave
• Paid caregiver leave
• Variety of training programs
• Professional development resources
• Opportunities to participate in mentorship programs
• Employee resource groups
• Volunteer activities

What This Job Offers

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