Nurse Case Manager - Montreal, QC
Division: Bayshore Specialty RX
Job Type: Part-Time (Wednesday, Thursday and Friday)
Employment Status: Permanent
Job Category: Bayshore Specialty RX
Years of Experience: 3-5
Number of Positions: 1
- Fluent English
- Fluent French
Contact Email: email@example.com
Bayshore is an Equal Opportuity Employer. We encourage all candidates who have the right mix of skills, abilities and a passion for excellence to apply.
Bayshore HealthCare is one of the country's leading providers of home and community health care services and a Canadian-owned company. Its services are purchased by government care programs, insurance companies, workers' compensation boards, health care organizations, the corporate sector and the public. The Bayshore brand extends across four business divisions: Bayshore Home Health (medical and non-medical home care and staffing services), Bayshore Specialty Rx (specialty pharmacy, infusion and pharmaceutical patient support services), Bayshore Therapy & Rehab (physiotherapy and rehabilitation services) and Bayshore Dialysis (dialysis centers). The company's goal is to enhance the quality of life, well-being, dignity and independence of Canadians of all ages. Bayshore HealthCare has been a recipient of Canada's 50 Best Managed Companies award since 2006.
*This part-time position is for three days a week (Wed, Thur &Fri)*
*Travel is required on a regular basis within Montreal and surrounding areas. The candidate should be located in Montreal.*
To be a single point of contact offering medical case management services to patients with Multiple Sclerosis as well as support to physicians with regards to the treatment reimbursement process. 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 resource to physicians who are prescribing this medication and continuous support for patients for on-going support, renewals, and coverage changes.
Duties and Responsibilities
- Ensure patient has been enrolled through support program
- Gather all pertinent and appropriate information from the patient and physician 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.
- Follow-up/advocate until a decision is received, ideally securing coverage for the patient.
- Proactively offer counseling, advocacy and assistance for patients.
- Work closely with the local sales representatives to support specific customer needs.
- Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients and clinics.
- Provide updates to stakeholders as requested.
- Potential for large amount of telephone support required along with travel.
- Participate in ongoing internal and/or external continuing education activities
- Adhere to Bayshore Policies and Procedures.
- Participate in quality activities and continuous improvement initiatives in keeping with the company’s Quality Management System
- Employee will maintain relevant level of knowledge of ICH (International Conference on Harmonization), GCP (Good Clinical Practice) and Health Canada GVP (Good Pharmocovigilance Practices) guidelines appropriate to their hired role which is to be provided at time of hire and annually. With this knowledge the employee will perform the work as required by their assigned function and will be provided with regular updates as required.
- Participate in processes relating to regulatory reporting requirements
- Maintain patient confidentiality in all communications, in accordance with relevant privacy legislation.
- Participates in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns. Responsible for completing Accident Reports for all direct reports who injure themselves on the job, within 24 hours of the incident.
- Maintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel
- Complete other tasks as requested
- Registered and in good standing with the College of Nurses
- Reimbursement experience 3+ years
- Measureable experience with patients suffering with Neurological disease states (3 years+), specifically Multiple Sclerosis.
- Understanding 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.
- Bilingual (French & English)- A strong asset
- Strong Computer and Technical skills: Excel, Word, Outlook, tablets, web-portals/internet use
- In home office space that is in a quiet area of the home. Is responsible for all associated costs in home office including the costs and connectivity associated with access to speed internet.
Ability to travel; own vehicle required. Willing to travel (as needed).
- Ease with working independently, making decisions using sound judgment, and meeting deadlines.
- Excellent written and verbal communication skills, data collection requirements
- Motivational Interviewing skills/experience an asset.
- You must reside in the province in which you provide support
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