Field Case Manager
$81,428–$131,428 year
RemoteOntario, Canada
Job Summary
Customize program elements for assigned prescribing physicians and review patient charts to complete payer forms, ensuring access to public or private coverage. Act as a liaison between physicians, clinics, and the Program Manager to resolve coverage obstacles and provide training on new initiatives. Coordinate reimbursement navigation, track patient services against KPIs, and assist patients with pharmacy selection and financial assistance. Complete all relevant reports, including program-specific data, expenses, and time sheets, per specified timelines and standards. Maintain ongoing communication with cross-functional teams, pharmaceutical representatives, and patients while reporting adverse events per Standard Operating Procedures.
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
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
- 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
- Fluency in French and English
- Daily contacts with unilingual English-speaking customers, patients or peers from cross-functional teams
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