Job Description

JOB SUMMARY
The 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.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 patients 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

physicians and staff needs, if applicable

• Offer and/or provide educational training to patients and physicians on product(s)

QualificationsQUALIFICATIONSEDUCATION
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

• 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

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

Bayshore HealthCare