- Professional
- Optionales Büro in Nashville
JOB SUMMARY
The Field Nurse Case Manager (FNCM) will play an essential role in supporting patients living with a
respiratory disease to improve both their health outcomes and quality of life. FNCM offers enrolment and
reimbursement support to physicians and medical case management services to patients. Assist the
physician with the completion of all program-specific paperwork and follow-up on submissions pertaining
to obtaining drug reimbursement/coverage through private and provincial drug formularies to ensure
patients have access to their prescribed treatments in a timely manner. Act as a key resource to physicians
who are prescribing this medication and continuous support for renewals, and coverage changes.
DUTIES AND RESPONSIBILITIES
• Assist the prescribing physician to complete patient enrolment; including on-site visits to the
physician office to gather 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.
• Review patient charts in physician office (paper and electronic based); keep electronic charts.
• Ensure patients are scheduled for blood work and notify physicians of expired blood work results.
• Complete Welcome Call activities with the patient according to defined scripts.
• Facilitate any required communication with physicians, Patient Assistant Programs or other health
care professionals involved in the patients’ circle of care.
• Follow-up/ advocate until a decision is received, ideally securing coverage for the patient.
• Work closely with the manufacturer local sales representatives to support specific physician’s and
staff needs.
• Offer and/ or provide educational training to patients and physicians on product’s administration.
• Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients
and clients.
• Provide updates to stakeholders based on observations in the field and physicians.
• Ensure patient records are maintained and data accurate to meet program reporting requirements.
• Must be able to identify and report AE’s 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.
• Maintains confidentiality of client and corporate information and discusses same only with
appropriate Bayshore personnel.
• Requires traveling to physician’s offices on a regular basis as requested by the physician’s office.
• Completes all relevant reports (time sheets, expenses, mileage, reports, 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.
QUALIFICATIONS
• Registered Nurse or Registered Practical Nurse (RN/RPN) license.
• Preference with candidate that have experience with the product.
• Registered and in good standing with the College of Nurses.
• Minimum 2 years’ experience in Patient Support Programs.
• Providing excellent customer services skills internally as well as externally.
• Excellent verbal and written communication skills and interpersonal skills; English and Bilingual is
servicing Quebec.
• Reimbursement experience
o Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.
o Familiarity with the Special Authorization process for both public and private insurance in assigned territory.
• Strong computer and technical skills: Excel, Word, Outlook, tablets, web-portals/internet use.
• Strong critical thinking and problem-solving skills.
• Making decisions using sound judgement, and meeting deadlines.
• 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.
• Valid driver’s license with less than 2 infractions in the past 2 years.