Customize program elements to meet the needs of assigned prescribing physicians
Review patient status and assist the prescribing physician to complete patient enrolment
Identify obstacles to obtaining coverage and channel this information to the Program Manager
Develop strong working relationships with physicians and physician office staff
Proactively provide assistance to resolve issues with regards to assigned physicians
Provide training to physicians and clinics on program and new initiatives approved by the manufacturer
Complete all relevant reports as per specified timelines and as per required standards
Welcome each patient to the program and capture required patient information
Provide reimbursement payer guidelines to patients and physicians
Ensure patient services are coordinated and tracked, according to KPI’s
Coordinate private and public coverage activity between patient, physician and insurers
Report Adverse Events / Severe Adverse Events following program Standard Operating Procedures
Assist in training and development of new FCM as needed
Complete all relevant reports as per specified timelines and as per required standards

A Bachelor’s degree in health care or a related discipline, or a nurse diploma
Requires a minimum five (5) years in the healthcare, pharmaceutical or insurance industry or related experience
Licensed Nurse (RN or RPN/LPN) with active registration from the College of Nurses in the province of employment is required
Case management experience preferred; minimum three (3) years nursing experience in a clinic setting is an asset
Valid Driver’s License, current auto insurance policy and access to reliable transportation for regional travel
Experience and background in various therapeutic areas is an asset
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.

Field Case Manager, RN/RPN/LPN

About this role