Nurse Case Manager (Contract)

at  Bayshore HealthCare

WHAT YOU BRING TO THE TEAM

• Graduate of 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.

The Nurse Case Manager (NCM) is dedicated to advocating for patients by advising them of prior authorization approvals, completing renewal forms, and liaising with third-party providers and provincial governments to secure optimal coverage. This role involves conducting welcome calls, following up on diagnostic tests, and providing patients and physicians with support and education. The specialist reviews post-visit reports, tracks missing information, and coordinates communication among healthcare professionals. Additionally, they work closely with manufacturer representatives to meet the needs of physicians and their staff, ensuring that patients receive the best possible care and support throughout their treatment journey. A key aspect of this role is offering educational training to patients about the products, empowering them with the knowledge needed for effective treatment.
This is a remote contract position for 12 months, open to candidates that reside in Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, Quebec, Saskatchewan, Northwest Territories, Nunavut, and Yukon.

A Day in the Life

• Assist in completing patient enrolment; including gathering all pertinent and appropriate information to complete the necessary forms (private and/or provincial insurance) in a concise, organized, and professional manner
• Liaise and advocate with third-party providers and provincial governments as necessary to determine coverage options
• Ensure patients are scheduled for necessary diagnostic tests and notify physicians of any expired test results that require follow-ups
• Complete Welcome Call activities with the patient according to defined scripts
• Provide patients and physicians with direct toll-free number
• Review post visit reports to confirm next appointment is scheduled and data integrity of the report against the physician order, if applicable
• Track missing post visit reports, if applicable
• Facilitate any required communication with physicians, Patient Support Programs, or other health care professionals involved in the patient’s circle of care
• Follow up and advocate until a decision is received, ideally securing coverage for the patient, if applicable
• Work closely with the manufacturer local sales representatives to support specific physician’s and staff needs, if applicable
• Offer and/or provide educational training to patients and physicians on product(s)
• Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics
• Coordinate and schedule patients at appropriate visit locations (home, clinic, etc.), if applicable
• Provide updates to internal and external stakeholders based on observations
• Ensure patient records are maintained and data-accurate to meet program reporting requirements
• Must be able to identify and report Adverse Events to Health Canada, Med Info, and enter into source system and third-party systems
• Report and document Adverse Events as per Pharmacovigilance requirements
• Participate in quality activities and continuous improvement initiatives in keeping with the company’s Quality Management System as well as specific performance indicators for the project
• Maintain confidentiality of pharmaceutical partner(s) and corporate information and discuss same only with appropriate Bayshore personnel
• Complete all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore’s policy, if applicable
• Complete product complaint reports
• Adhere to Bayshore and manufacturer Policies and Procedures
• Complete other tasks, as requested

Job Qualification