Field Case Manager - 20-Month Contract
$66,352–$132,704 year
RemoteBritish Columbia, Canada
Job Summary
Customize program elements for assigned prescribing physicians and review patient charts to complete payer forms for public or private coverage. Identify coverage obstacles, channel information to the Program Manager, and provide training to physicians and clinics on new initiatives. Act as a liaison to resolve physician issues, coordinate reimbursement navigation between patients and insurers, and report adverse events per Standard Operating Procedures. Mentor new Field Case Managers, maintain relationships with office staff and pharmaceutical representatives, and complete all relevant reports including time sheets and expenses. On-call rotation may be required. Full-time contract with comprehensive benefits.
Required Qualifications
- Bachelor's degree in health care or a related discipline, or a nurse diploma
- Minimum five (5) years, in the healthcare, pharmaceutical or insurance industry or related experience
- Licensed Nurse (RN or RPN/LPN) with active registration from the College of Nurses in the province of employment
- Available to travel within an assigned territory, some overnight travel may be required
- Valid Driver's License, current auto insurance policy and access to reliable transportation, for regional travel
- Fluency in French and English
- Knowledge of private and public reimbursement structure, systems, and process
- Experience with reimbursement navigation, special authorization, appeals process and conducting field-based reimbursement support and consultation
- Strong analytical skills including interpretation of regulation and legislation
Desired Qualifications
- Case management experience
- Minimum three (3) years nursing experience in a clinic setting
- Experience and background in various therapeutic areas
- Background in business administration (pharmaceutical) sales and marketing
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