Gestionnaire de cas infirmier(ère) bilingue / Bilingual Nurse Case Manager

The Nurse Case Manager is an integral part of the Patient Services team, responsible for the coordination and delivery of services related to the patient support programs offered by McKesson Specialty. The role involves interactions with patients, insurance companies, pharmacies, physicians and other health care professionals (HCPs) and provide support to their patients.  The role involves understanding, adherence to corporate, divisional, departmental, and program specific standard operating procedures. This role is a full time, permanent position with rotating evening shifts (12pm-8pm) availability required.

Specific Responsibilities

• The Nurse Case Manager is the point of contact for the program, doctors, pharmacies and other HCP’s
• During the first 3-4 months of hire, NCM will be meeting key clinics for a face to face meet and greet to develop ongoing relationship with the clinics
• May be required to provide training and educational materials to patients pertaining to their medication and conduct adherence follow ups
• Review, analyze and validate information provided by patients and HCPs for accuracy and completeness to ensure initiation of services
• Follow the program protocols to ensure that the most appropriate next step is scheduled to ensure continuity of service delivery to HCPs and patients
• Complete follow ups with patients on behalf of the physician offices, as required, to ensure adherence to treatment regimens
• Liaise with the patient, insurer and physician regarding the documentation required for maximum reimbursement coverage, including the exploration of all public and private insurers and providing employer escalations as required
• Process data entry activities of pertinent information received at different points of contact during the delivery of program services
• Provide answers to general inquiry calls submitted via telephone, web-based platforms or in person, on program services, disease state or product related questions, based on information provided as part of the program materials
• Provide HCP and Patients with a technical product overview when required
• Liaise with physicians’ offices, services providers and other parties to provide comprehensive and coordinated service to patients and physicians
• Receive, record and report Adverse Events, as per program working instructions
• Maintain service levels in case management, including Adverse Events reported within twenty-four hours of receipt and any other Key Performance Indicators established at the Program level
• Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, general administrative functions including faxing, filing, scanning
• Other duties as assigned.

General Responsibilities

• Adhere to professional standards as prescribed by the professional associations and     McKesson as applicable
• Participate and assist in departmental continuous improvement activities related to process, quality, training
• Participate in the development of reports and tools for identifying signals that will flag misunderstanding, misconduct, fraud or other out of protocol program participant related incidents
• Assist with reviews of aggregate data to identify program trends and communicate these trends appropriately  
• Maintain program data accuracy through review of program documentation for completeness and consistency
• Support patients and HCPs with training, education and Injection services
• Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, general administrative functions including faxing, filing, scanning
• Act as lead point of contact between the program and stakeholders and works with clinics and client sales reps.

Job Requirements

Knowledge/Education

• Registered Nurse with current registration
• Understanding and compliance with corporate, divisional, departmental and program   specific standard operating procedures.

Experience

• More than one year and up to three years experience in a previous job or jobs
• Demonstrated ability to communicate efficiently and in an empathetic manner over the phone and in person
• Experience in the healthcare industry including, but not limited to medical claims, insurance verification, pharmacy and/or pharmaceutical manufacturers is preferable.

Key Competencies

Computer/Application Skills

• Required to use menu-driven retrieval and search functions on Windows based applications, web-based applications and proprietary information technology systems; ability to use a switch-based telephony software, etc.

Problem Solving

• Navigates quickly and effectively to resolve problems and obstacles, even when complex and unique circumstances occur; responds to recurring problems by investigating the underlying causes and taking steps to eliminate them. Only difficult problems are referred to supervisor

External Customer Service 

• Excellent customer service skills in dealing with patients, physicians, and other clients 
• Resolve customer complaints.

Planning/Coordinating Work

• Required to initiate planning and coordination of activities with other members in the work group, make appropriate adjustments to one’s own work plans

Innovation/Proactivity

• Expected to suggest innovations to the supervisor, which affect the job or its workflow. Tries different approaches when initial efforts to solve problems fail; anticipates possible problems and develops alternatives

Working Conditions

• Able to work independently and make appropriate decisions
• May be required to rotate shifts

Language Skills

• Ability to communicate written and verbally in both English and French

Travel

• Up to 10% of travel may be required
• Valid driver’s license required
• Ability to apply for corporate credit card for travel expenses.