Bilingual Field Case Manager

Role Overview

• Reviews patient status and assists the prescribing physician to prepare Special Authorization (SA) petitions for public or private coverage by reviewing patient charts, assessing previous therapies and tests in order to complete the SA
• Provides therapy guidelines/education on the program to manage patient and physician expectations
• Ensures patient services are coordinated and tracked in a timely manner resulting in quick and continued access to therapy
• Administer medications (IV, IM and SC) in the patient’s home or specialty clinics setting
• Monitor post-injection/infusion treatments as well as chart and report on all activities as directed by program protocols
• Provide patient education based on program protocols, individually or in groups
• Regular, predictable availability to meet appointment scheduling needs in an efficient and cost effective manner to provide patients with quick access to necessary therapies
• Coordinate daily with patients, case managers, physicians, scheduling and other departments to meet established timelines for scheduling appointments, treatments, and communication of information
• Participates in scheduled KOL physician meetings with pharmaceutical representative
• Proactively provides assistance to resolve client issues with regards to assigned physicians
• Reports Adverse Events / Severe Adverse Events (AE / SAEs) following approved SOP’s
• Electronically updates the Customer Relationship Management (CRM) tool by providing timely patient and clinic information
• Fosters and promotes a spirit of teamwork while working with internal support teams
• Develops and maintains a positive relationship with the Program Patient Support team
• Participate regularly in telephone consultations and/or web based meetings/training sessions with the District Manager to share information, and uphold professional practice standards
• Consult with physicians, pharmaceutical and biotechnology clients regarding education and implementation of product specific programs
• Supports and assists peers through regular and ongoing communication
• Acts a liaison and provides ongoing feedback to the Program Manager and or the Assistant Program Manager based on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance
• Identifies obstacles to obtaining coverage and channels this information to the Program Manager and/or Assistant Program Manager
• Completes all relevant reports (time sheets, expenses, mileage, validate CRM reports, etc.) as per specified timelines and as per required standards

Requirements

• Qualified registered nurse (RN) diploma and/or Nursing Bachelor Degree
• Registration with the College of Nurses in the province of employment is required
• Healthcare provider CPR certificate required
• 3 to 5 years of nursing experience required
• 1 year of regular IV initiation and infusion experience
• Experience in a critical care, emergency, acute care inpatient/outpatient or homecare setting are considered assets
• ACLS, CVAA Certification, and central venous lines/port experience are considered assets
• Knowledge of private and public reimbursement structure, systems, and process
• Experience with reimbursement billing, special access, appeals process and conducting field-based reimbursement support and consultation is an asset
• Access to a home computer with an internet connection, printer, fax machine, and cell phone for making and confirming appointments/assignments
• Flexibility to provide services for pre-scheduled and occasional last minute patient appointment requests
• Able to work autonomously with little supervision as part of a larger remote team
• Able to travel to clinics and homecare appointments within a set geographical boundary

Benefits

• Health insurance
• Backup dependent care
• Adoption assistance
• Infertility coverage
• Family building support
• Behavioral health solutions
• Paid parental leave
• Paid caregiver leave
• Professional development resources
• Mentorship programs
• Employee resource groups
• Volunteer activities