Field Case Manager supporting Canadian patients and physicians with pharmaceutical reimbursement and therapy access.
Coordinating enrollment, coverage navigation, drug delivery, therapy status, and patient support programs.
Responsibilities
Customize program elements to meet the needs of assigned prescribing physicians
Review patient status and assist physicians with patient enrolment and payer forms
Identify coverage obstacles and communicate them to the Program Manager
Build relationships with physicians and physician office staff and provide office support
Resolve issues for assigned physicians
Train physicians and clinics on programs and manufacturer-approved initiatives
Liaise with physicians and provide feedback to the Program Manager
Complete program, expense, timesheet, mileage, and other required reports
Welcome patients and capture required information
Provide reimbursement guidance and coordinate public/private coverage activity
Track patient services to expedite therapy access
Navigate financial assistance, pharmacy selection, drug delivery, and therapy coordination
Refer patients with clinical questions outside program materials to healthcare providers
Report adverse and severe adverse events according to standard operating procedures
Train and support new Field Case Managers and assist peers
Maintain relationships with the Patient Support Program team
Participate in physician meetings and continuing medical education events
Provide in-service presentations to physicians with Pharmaceutical Representatives
Maintain communication with program stakeholders
Perform other assigned duties and participate in standby/on-call coverage as required
Requirements
Bachelor’s degree in health care or a related discipline, or a nurse diploma
Minimum five years of experience in healthcare, pharmaceutical, insurance, or related industry
Active RN or RPN/LPN registration with the College of Nurses in the province of employment
Case management experience preferred
Minimum three years of nursing experience in a clinic setting is an asset
Availability to travel within an assigned territory; some overnight travel may be required
Valid driver’s license, current auto insurance, and reliable transportation for regional travel
Experience across various therapeutic areas is an asset
Knowledge of private and public reimbursement structures, systems, and processes
Experience with reimbursement navigation, special authorization, appeals processes, and field-based reimbursement support and consultation
Strong analytical skills, including interpretation of regulations and legislation
Fluency in French and English is an asset
Ability to have daily contact with unilingual English-speaking customers, patients, or cross-functional peers
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