Nurse Case Manager

Bayshore•Vancouver, BC

3d•Remote

About The Position

The Nurse Case Manager (NCM), also referred to as a Regional Support Nurse, will serve as a primary point of contact for patients requiring medical case management services for Neurology treatments. This role also involves supporting physicians with the reimbursement process for these treatments. The NCM will assist physicians in completing all necessary program-specific paperwork and follow up on submissions to secure drug reimbursement or coverage through private and provincial drug formularies, ensuring timely access to prescribed treatments for patients. Additionally, the NCM will act as a resource for prescribing physicians and provide continuous support to patients regarding ongoing treatment, renewals, and changes in coverage.

Requirements

Graduate of a Registered Nursing Program or Registered/Licensed Practical Nursing program holding current registration from a provincial licensing body in Canada.
Registered and in good standing with their provincial regulatory body.
Minimum 2 years’ experience in Patient Support Programs or equivalent.
Demonstrated expertise in delivering exceptional customer service and fostering positive relationships with internal and external stakeholders.
Must be fluent in verbal and written communication and interpersonal skills for both English and French (Applicable for provinces/regions with French language service requirements).
Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset.
Strong computer and technical skills: Excel, Word, Outlook, tablets, web portals/internet use.
Strong critical thinking and problem-solving skills.
Making decisions using sound judgment.
Proficient with 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.
Ability to work in a quiet working environment with proven ability to work autonomously within a remote/virtual team environment.
Established high speed internet access from home office.

Nice To Haves

Measurable experience with patients suffering with Neurological disease states (at least 3 years of experience), specifically Multiple Sclerosis.
All RNs and RPNs working on the program should become MS certified by the CAN or IOMSN within 2 years of working on the program unless approved by client.

Responsibilities

Assist in completing patient enrollment, including gathering all pertinent information for insurance forms.
Liaise and advocate with third-party providers and provincial governments to determine coverage options.
Ensure patients are scheduled for necessary diagnostic tests and notify physicians of expired test results.
Complete Welcome Call activities with patients according to defined scripts.
Provide patients and physicians with a direct toll-free number.
Review post-visit reports to confirm next appointment scheduling and data integrity.
Track missing post-visit reports.
Facilitate communication with physicians, Patient Support Programs, and other healthcare professionals.
Follow up and advocate until a coverage decision is received.
Work closely with manufacturer local sales representatives to support physician and staff needs.
Offer and/or provide educational training to patients and physicians on product(s).
Act as a central resource liaison for program stakeholders, including physicians, nurses, patients, and clinics.
Coordinate and schedule patients at appropriate visit locations (home, clinic, etc.).
Provide updates to internal and external stakeholders based on observations.
Ensure patient records are maintained and data-accurate for program reporting.
Ensure timely and compliant reporting of Adverse Events (AEs) and Product Quality Complaints (PQCs) in accordance with Health Canada pharmacovigilance requirements.
Participate in quality activities and continuous improvement initiatives.
Maintain confidentiality of pharmaceutical partner and corporate information.
Complete all relevant reports (time sheets, expenses, mileage, 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.