Bilingual Nurse Case Manager


Website Bayshore HealthCare

About the RoleBilingual Nurse Case Manager (NCM) will play an essential role in supporting patients living with HIV disease to improve both their health outcomes and quality of life. NCM offers enrolment and reimbursement support to physicians and 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.

NCM will also supervise the coordination of monthly injection.A Day in the LifeRemotely assist the prescribing physician to complete patient enrolment; gather 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 monthly injection.Complete Welcome Call activities with the patient according to defined scriptsFacilitate 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.Offer and/or provide educational training to patients and physicians on product’s administrationAct as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics and pharmacies.Provide updates to stakeholders based on observations in the field and physician’sEnsure 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 systemsReport and document Adverse Events as per Pharmacovigilance requirementsParticipate in quality activities and continuous improvement initiatives in keeping with the company’s Quality Management System as well as specific performance indicators for the projectMaintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnelCompletes all relevant reports as per specified timelines and Bayshore’s policyComplete product complaint reportsAdhere to Bayshore and manufacturer Policies and ProceduresComplete other tasks as requestedJob QualificationWhat You Bring to the TeamRegistered Nurse or Registered Practical Nurse (RN/RPN) LicenseBilingual in French and EnglishExperience with private and public payer is a strong assetExperience in HIV is an assetRegistered and in good standing with the College of NursesMinimum 2 years’ experience in Patient Support ProgramsProviding excellent customer services skills internally as well as externallyExcellent verbal and written communication skills and interpersonal skills; English and FrenchUnderstanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape.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 useStrong critical thinking and problem-solving skillsMaking decisions using sound judgment, and meeting deadlines.Accurate data collection and data integrityEase with working in a paperless environment.Ability to drive for resultsProven ability to work in a team environmentAbility to resolve conflict in a professional matterStrong sense of organization and attention to detailSelf-regulation of time management and the ability to multi-task and adhere to deadlinesFamiliarity with PIPEDA and how it applies in a confidential patient environment.


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