Nurse Case Manager

Bayshore HealthCare; Mississauga; Remote; CAD 67,000 - 84,000; Full time

Job summary

Bayshore Healthcare in Mississauga, ON, is seeking a Nurse Case Manager to serve as a single point of contact for Neurology patients, supporting physicians with drug reimbursement processes and coverage navigation.

The role involves enrolment, liaising with insurers and governments, coordinating tests and follow-ups, and ensuring timely access to prescribed therapies; strong nursing credentials and multi-tasking are essential, with English and French communication valued.

Qualifications

• Registered nursing or RN/LPN with current provincial registration in Canada.
• Minimum 2 years in patient support programs or equivalent.
• Strong communication, organizational, and data-entry skills.

Responsibilities

• Assist in patient enrolment and gather information for forms.
• Advocate with third parties and governments to determine coverage options.
• Coordinate tests, follow-ups, and renewals for drug reimbursement.
• Maintain patient records and ensure data integrity for reporting.
• Provide education to patients and physicians on product use and coverage.

Skills

Communication skills

English and French proficiency

Team collaboration

Data entry / administrative skills

Education

Registered Nursing Program or Registered/Licensed Practical Nursing program

Tools

Excel

Word

Outlook

Tablets

Web portals

Job description

Nurse Case Manager(Job Number: 26005772)Primary Location:ON-Mississauga Pharma Employee Type:Full-Time Pay Rate From:$67,200 Pay Rate To:$84,000Description:JOB SUMMARYThe Nurse Case Manager (NCM) that is referred to as a Regional Support Nurse in this program is to be a single point of contact offering medical case management services to patients with Neurology 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• 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 Safety Events (Adverse Events, Product Quality Complaints, Special Situations) to relevant entities (e.g. Health Canada, Med Info, PV team) and in conjunction with the Pharmacovigilance Department assures the identification, datacollection into source system and third-party systems, processing and reporting of Safety Events are within contractual KPI’s and 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 requestedQualifications:QUALIFICATIONSEducation• Graduate of Registered Nursing Program or Registered/Licensed Practical Nursing programholding 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.• Must be fluent in verbal and written communication and interpersonal skills for both English and French (Applicable for provinces/regions with French language service requirements).• Understanding of provincial and private coverage criteria, Special Authorization processesand 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 & Abilities• Measurable experience with patients suffering with Neurological disease states (at least 3 years of experience), specifically Multiple Sclerosis.• All RNs and RPNs working on the program should become MS certified by the CAN or IOMSN within 2 years of working on the program unless approved by client.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.