Field Case Manager

Location

150 - 8518 Glenlyon Parkway, Burnaby, British Columbia, V5J 0B6

At Shoppers Drug Mart, we’re innovating health and wellness in Canada. From prescriptions to walk‑in clinics, and a beloved loyalty program, we’re caring and supporting our customers in new ways every day. With more than 1,300 locally owned and operated stores from coast to coast, the Shoppers Drug Mart network is more than a great place to shop, it’s a great place to work.

We’re committed to building our talented team who champion collaboration, kindness and inclusivity. Join our team, and help recognize a healthy future for your career and for all Canadians.

The Nurse Field Case Manager (FCM) is responsible for a collaborative process of ongoing assessment, planning, facilitation, service coordination, evaluation, and advocacy to meet the needs of the patient/physician/client through flawless customer service. The Nurse Field Case Manager will deliver, through expert communication skills and available resources, quality and cost‑effective treatment outcomes for the patient. The Nurse Field Case Manager will work directly with the reimbursement team to help secure drug coverage.

They will support physicians in managing all aspects related to facilitating patient access to therapy and will provide service in person or remotely according to customer preference. The Nurse Field Case Manager will help support a busy caseload in their respective territory, building strong working relationships, collaboration, effective communication and attention to detail both internally and externally to meet specific team and business objectives.

In addition, the Nurse Field Case Manager will attend training sessions, complete self‑learning assignments and independent studies while adhering to SDM Specialty Health Network Standard Operating Procedures, Policies, and the College of Nurses Standards of Practice.

• Assist the health care practitioner (HCP) in completing the Program enrolment form, as applicable.
• Educate the HCP on the Program enrolment requirements.
• Gather patient Program enrolment required information (physician signature, patient contact information, and product information).
• Provide reimbursement assistance to patients and physicians according to need.
• Provide physicians with payer documentation support.
• Investigate case‑by‑case reimbursement options, channels, procedures, and prepare documentation in support of reimbursement requests.
• Determine patients’ channels and eligibility for reimbursement and provide assistance at all levels.
• Review patient status and assist the prescribing physician to populate Special Authorization forms (SA) for public or private coverage by reviewing patient charts, assessing previous therapies and test results to complete the SA. The above may be done on site, or remotely, as required.
• Ensure the coordination and follow‑up of SA submissions with payers.
• Support treating physician in the development of appeal letters, as required.
• Act as a resource for treating physicians and provide guidance regarding payer reimbursement criteria.
• Assist patients and physicians with the annual prescription renewal process.
• Assist patients and physicians with the SA renewal process (most commonly annually), as applicable.
• Identify obstacles and delays to obtaining coverage, take appropriate action and identify alternative channels for patient coverage.
• Manage patient files in the program database.
• Educate the HCP and patients regarding Program services by providing general Program and Product information based on SOPs, Product Monograph, approved verbatim and other approved materials.
• Review and discuss comprehensive program components, services and value‑add program offerings.
• Act as a liaison and provide ongoing feedback to manufacturers based on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance. Feedback and observations are channeled to the manufacturer as appropriate.
• Collaborate with sales reps and associates according to guidance and guidelines.
• Attend scheduled educational events…