Nurse Case Manager

JOB SUMMARY
The Nurse Case Manager (NCM) provides comprehensive case management and support to patients and healthcare professionals throughout the patient journey. The NCM acts as a central point of contact, helping patients navigate program services, treatment access, reimbursement and coverage requirements, while facilitating timely communication and coordination among patients, healthcare providers and other program stakeholders. The NCM provides ongoing education, guidance and advocacy to support continuity of care and a positive patient experience, while ensuring accurate documentation and adherence to program, quality, privacy and pharmacovigilance requirements.

DUTIES AND RESPONSIBILITIES
• Assist in completing patient enrolment; including gathering 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.
• Ensure patients are scheduled for necessary diagnostic tests and notify physicians of any expired test results that require follow-ups.
• Complete Welcome Call activities with the patient according to defined scripts.
• Provide patients and physicians with direct toll-free number.
• Review post visit reports to confirm next appointment is scheduled and data integrity of the report against the physician order, if applicable.
• Track missing post visit reports, if applicable.
• Facilitate any required communication with physicians, Patient Support Programs, or other health care professionals involved in the patient’s circle of care.
• Follow up and advocate until a decision is received, ideally securing coverage for the patient, if applicable.
• Work closely with the manufacturer local sales representatives to support specific physician’s and staff needs, if applicable.
• Offer and/or provide educational training to patients and physicians on product(s).
• Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics.
• Coordinate and schedule patients at appropriate visit locations (home, clinic, etc.), if applicable.
• Provide updates to internal and external stakeholders based on observations.
• Ensure patient records are maintained and data-accurate to meet program reporting requirements.
• Must be able to identify and report Adverse Events 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.
• Maintain confidentiality of pharmaceutical partner(s) and corporate information and discuss same only with appropriate Bayshore personnel.
• Complete all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore’s policy, if applicable.
• Complete product complaint reports.
• Adhere to Bayshore and manufacturer Policies and Procedures.
• Complete other tasks, as requested.

QUALIFICATIONS
Education
• Graduate of Registered Nursing Program or Registered/Licensed Practical Nursing program holding current registration from a provincial licensing body in Canada.

Experience
• Registered and in good standing with their provincial regulatory body.
• Minimum 2 years’ experience in Patient Support Programs or equivalent.
• Demonstrated expertise in delivering exceptional customer service and fostering positive relationships with internal and external stakeholders.
• Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset.
• Strong computer and technical skills: Excel, Word, Outlook, tablets, web portals/internet use.
• Strong critical thinking and problem-solving skills.
• Making decisions using sound judgment.
• Proficient with 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.
• Ability to work in a quiet working environment with proven ability to work autonomously within a remote/virtual team environment.
• Established high speed internet access from home office.

OTHER SKILLS AND ABILITIES
• Valid and current nursing registration/license in good standing with the applicable provincial regulatory body

At Bayshore Healthcare, our commitment to Equity, Diversity & Inclusion is our strength. This is how we bring our vision of being the difference in the lives of those we care for, work with and in our communities. We have a great sense of pride in creating a culture of belonging, where individual differences are embraced and celebrated, through programs, resources and policies that support each individual's purpose, potential and wellbeing.

At Bayshore Healthcare Ltd., and its subsidiaries, we are committed to fostering an inclusive workplace and operate in full compliance with all Provincial and Territorial legislation pertaining to Human Rights Codes and Accessibility requirements. To ensure continued compliance throughout the recruitment and selection process, we encourage candidates to disclose any accommodation needs they may have.