Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!

Job Details

Principales fonctions et responsabilités :

Gestion de la pratique

Personnaliser les éléments de programme pour répondre aux besoins des médecins prescripteurs désignés;
Veiller au respect des normes régissant les soins infirmiers de l’Ordre des infirmiers et infirmières;
Passer en revue l'état du patient et aider le médecin prescripteur à compléter »l’inscription des patients, à préparer les demandes d'autorisation spéciale (AS) pour l'assurance publique ou privée en examinant les dossiers des patients et en évaluant les thérapies et les tests précédents afin de remplir les demandes d’AS;
Évaluer de manière proactive les programmes et faire des suggestions pour améliorer les résultats et la qualité de service;
Remplir tous les rapports pertinents (rapports propres au programme, dépenses, etc.) conformément aux échéanciers précisés et selon les normes requises.

Soutien aux patients

Accueillir chaque patient au programme et prendre en note les informations requises sur le patient;
Fournir des lignes directrices de traitement aux patients et aux médecins;
S'assurer que les services aux patients sont coordonnés et suivis, selon les indicateurs de rendement clés (IRC), résultant en l'accès accéléré à la thérapie;
Coordonner l'activité de couverture d'assurance privée et publique directement avec les assureurs suivant les procédures opérationnelles normalisées;
Faire le suivi avec le patient des résultats de la navigation pour obtenir un remboursement;
Fournir de l'information et explorer l'aide financière avec le patient
Aider le patient à choisir une pharmacie et coordonner la livraison de médicaments;
Contribuer à la coordination du traitement et à la surveillance continue du patient en collaboration avec le patient;
Signaler les effets indésirables/effets indésirables graves suivant les procédures opérationnelles normalisées du programme.
Identifier les obstacles à l'obtention de la couverture d’assurance et transmettre ces renseignements au gestionnaire de programme et/ou au gestionnaire adjoint de programme;

Mentorat/Soutien des pairs

Contribuer à la formation et au développement de nouveaux GCA au besoin
Soutenir et aider les pairs par une communication régulière et continue;
Établir et maintenir une relation positive avec l’équipe de Soutien aux patients du programme;
Fournir des renseignements sur le patient et la clinique en temps opportun, selon les besoins, en ayant recours aux moyens spécifiques utilisés par le programme.

Interface client

Participer à des réunions planifiées des médecins KOL avec les représentants des ventes;
Établir de solides relations de travail avec les médecins et le personnel de bureau, en fournissant un soutien administratif additionnel pour garantir la gestion harmonieuse des patients inscrits au programme, au besoin;
Offrir une aide proactive pour résoudre les préoccupations des clients en ce qui concerne les médecins désignés;
Assister aux événements planifiés de formation médicale continue et faire rapport des nouvelles activités;
Animer des présentations aux médecins KOL en collaboration avec les représentants des ventes sur les nouveaux programmes;
Donner une formation aux médecins et aux cliniques sur le programme et les nouvelles initiatives approuvées par le client.;
Assurer la liaison et fournir une rétroaction continue au Programme d'aide aux patients en fonction des observations sur le terrain et des commentaires des clients en ce qui a trait à la qualité des services, la formation et autres aspects importants;
Assurer une communication continue avec le gestionnaire de programme, les médecins, le personnel de bureau, les représentants des clients, les patients et l’équipe des soins infirmiers, selon les besoins.

Autre

Remplir tous les rapports pertinents (feuilles de temps, dépenses, kilométrage, rapports, etc.) selon les échéanciers prévus et les normes applicables;
D'autres fonctions et tâches peuvent être confiées au gestionnaire de cas sur le terrain de temps à autre, selon les besoins.
Son travail peut exiger qu’il soit sur appel ou de garde.

Primary duties and responsibilities:

Practice Management

Customize program elements to meet the needs of assigned prescribing physicians;
Review patient status and assist the prescribing physician to complete patient enrolment, prepare payer forms to access public or private coverage by reviewing patient charts, documenting previous therapies and tests in order to complete the payer forms;
Identify obstacles to obtaining coverage and channel this information to the Program Manager;
Develop strong working relationships with physicians and physician office staff, providing additional office support to ensure smooth maintenance of patients enrolled in the program as needed;
Proactively provide assistance to resolve issues with regards to assigned physicians;
Provide training to physicians and clinics on program and new initiatives approved by the manufacturer;
Acts as a liaison and provide ongoing feedback to the Program Manager based on observations in the field and feedback from physicians as it pertains to quality of services, training, and other areas of importance;
Complete all relevant reports (program specific reports, expenses, etc.) as per specified timelines and as per required standards.

Patient Support (Based on program design some Field Case Managers may have limited or no patient interactions)

Welcome each patient to the program and capture required patient information;
Provide reimbursement payer guidelines to patients and physicians;
Ensure patient services are coordinated and tracked, according to KPI’s, resulting in expedited access to therapy;
Coordinate private and public coverage activity between patient, physician and insurers;
Confirm outcome of reimbursement navigation with the patient;
Provide information and navigate patient through financial assistance;
Assist patient with pharmacy selection and coordinate drug delivery;
Assist patient with coordination of therapy and ongoing therapy status;
Refer the patient to contact their healthcare provider should the patient have clinical questions, assessments and situations that fall outside program provided materials or manufacturer product monograph;
Report Adverse Events / Severe Adverse Events following program Standard Operating Procedures;

Mentorship/Peer Support

Assist in training and development of new FCM as needed;
Support and assist peers through regular and ongoing communication;
Develop and maintain a positive relationship with the Patient Support Program team;
Provide timely patient and clinic information as needed, through specific means used by the program.

Manufacturer Interface

Participate in scheduled physician meetings with Pharmaceutical team;
Attend scheduled Continuous Medical Education events and reports new activities;
Provide in service presentation to physicians in collaboration with the Pharmaceutical Representatives.

Other

Ongoing maintenance of communication with Program Manager, physicians, physician office staff, client representatives, patients and nursing team as required;
Complete all relevant reports (time sheets, expenses, mileage, reports etc.) as per specified timelines and as per required standards.
The Field Case Manager will also be assigned other duties and tasks as required from time to time.
May be required to be on standby/ on call as part of this role.

Expérience et niveau d’éducation requis :

IA ou IAA; Inscription à l'Ordre des infirmières et infirmiers de l’Ontario; expérience en gestion de cas est préférable;
Minimum de trois (3) ans d’expérience dans un milieu clinique constitue un atout;
Disponible pour voyager à l'intérieur d'un territoire assigné, quelques voyages avec nuitées peuvent être nécessaires;
BCLS peut être nécessaire selon le domaine thérapeutique du programme;
Permis de conduire valide, police d'assurance automobile courante, et accès à des moyens de transport fiables, pour les voyages régionaux;
Expérience et formation dans divers domaines thérapeutiques constitue un atout;
Exige normalement un minimum de trois (3) à cinq (5) ans d’expérience dans le domaine du remboursement par des tiers publics ou privés, ou de l'industrie pharmaceutique dans les ventes, la gestion des soins, ou le soutien clinique;
Antécédents en administration des affaires (pharmaceutique) en ventes et en marketing constitue un atout;
Connaissance de la structure, des systèmes et processus de remboursement public et privé;
Expérience de la navigation en vue d’obtenir un remboursement, du processus de demande autorisation spéciale, des procédures de recours, et de la prestation d’un soutien et de conseils en matière de remboursement sur le terrain;
Solides compétences analytiques, y compris l’interprétation de la réglementation et la législation;
Maîtrise du français et de l’anglais est requis.
Il s’agit d’un contrat de 22 mois.

Le candidat retenu aura avoir des contacts quotidiens avec des clients, des patients ou des pairs unilingues anglophones d'équipes interfonctionnelles.

Experience and educational requirements:

A Bachelor’s degree in health care or a related discipline, or a nurse diploma;
Requires a 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 is required. Case management experience preferred; minimum three (3) years nursing experience in a clinic setting is an asset
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;
Experience and background in various therapeutic areas is an asset;
Background in business administration (pharmaceutical) sales and marketing an asset;
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 is required;
It is a 22 - month contract role.

The successful candidate will have daily contact with unilingual English-speaking clients, patients or peers from cross-functional teams.

#LI-NA1

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

Full time

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.

The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned

Accessibility Policy

Cencora is committed to fair and accessible employment practices. When requested, Cencora will accommodate people with disabilities during the recruitment, assessment and hiring processes and during employment.

Affiliated Companies:

Affiliated Companies: Innomar Strategies

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