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Job Title: | Nurse Reimbursement Case Manager |
Job Type: | Full-Time |
Location: | Hamilton, ON |
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Job Category: | Pharmacy |
Level: | Support |
Industry: | Healthcare |
Company URL: | www.bayshore.ca |
Years of Experience: | 3+ |
Number of Positions: | 1 |
Languages: | English |
Date Posted: | 2/15/2013 |
Contact Email: | jloney@bayshore.ca |
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Bayshore HealthCare
Bayshore HealthCare is one of the country’s leading providers of home and community health care services and a Canadian-owned company. Its services are purchased by government care programs, insurance companies, workers’ compensation boards, health care organizations, the corporate sector and the public. The Bayshore brand extends across four business divisions: Bayshore Home Health (medical and non-medical home care and staffing services), Bayshore Specialty Rx (specialty pharmacy, infusion and pharmaceutical patient support services), Bayshore Therapy & Rehab (physiotherapy and rehabilitation services) and Bayshore Dialysis (dialysis centers). The company’s goal is to enhance the quality of life, well-being, dignity and independence of Canadians of all ages. Bayshore HealthCare has been a recipient of Canada’s 50 Best Managed Companies award since 2006.
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Job Summary:
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To provide administrative/program support to physicians and provide medical case management services to patients. Assist with the completion of all program-specific paperwork and follow up on the submissions pertaining to obtaining drug reimbursement/coverage through private and provincial drug formularies. Provide resources to physicians who are prescribing this medication and support for patients. This position reports into the Project Leader.
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Duties and Responsibilities:
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Ensure patient has been enrolled through support program
Review patient charts in physician office (paper and electronic based); keep electronic charts
Gather all pertinent and appropriate information from the chart and complete the necessary forms in a concise, organized and professional manner.
Follow/advocate until a decision is received where related to securing coverage
Updates provided to stakeholders as requested
Counseling, advocacy and assistance for patients
Works closely with the local sales representatives to support specific customer needs.
Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients and clinics.
Potential for large amount of telephone support required along with travel.
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Experience:
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Reimbursement experience 3+ years
Knowledge of inflammatory disease; experience in Rheumatology and Dermatology an asset.
Understanding of provincial and private coverage criteria and how to navigate Special Authorization process of public and private insurance
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Education:
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RPN, RN, Reimbursement Navigation (Public and Private payers) experience
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Other Information:
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Position responsible for Hamilton/Niagara and surrounding area.
Strong Computer skills: Excel, Word, Outlook
Access to internet from home office
Ability to travel; own vehicle required
Work independently; meet deadlines and data collection requirements
Excellent written and verbal communication skills
Please ensure that you reference the job title in the subject line of your email.
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How to Apply:
Bayshore is an Equal Opportunity Employer. We encourage all candidates who have the right mix of skills, abilities and a passion for excellence to apply. Please submit your resume through one of the following ways:
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