Nurse Case Manager

Job Summary To be a Nurse Case Manager offering reimbursement support to physicians and medical case management services to patients. Assist the physician with the completion of all program‐specific paperwork and follow‐up on submissions pertaining to obtaining drug reimbursement/coverage through private and provincial drug formularies to ensure patients have access to their prescribed treatments in a timely manner. Act as a resource to physicians who are prescribing this medication and continuous support for patients for on‐going support, renewals, and coverage changes. This position reports into the Program Manager. Duties And Responsibilities 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 to complete the necessary forms (private and/or provincial insurance) in a concise, organized, and professional manner. Liaise and advocate with third‐party providers and provincial governments as necessary to determine coverage options. Follow‐up/advocate until a decision is received, ideally securing coverage for the patient. Proactively offer counseling, advocacy, and assistance for patients. Work 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. Provide updates to stakeholders as requested. Potential for large amount of telephone support required along with travel. Participate in ongoing internal and/or external continuing education activities. Adhere to Bayshore Policies and Procedures. Participate in quality activities and continuous improvement initiatives in keeping with the company's Quality Management System as well as specific performance indicators for the project. Participate in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate Supervisor of any Health & Safety risks or concerns. Must be able to identify and report AE’s to health Canada, Med Info and enter into source system and third party systems. Report and document Adverse Events as per Pharmacovigilance requirements. Maintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel Complete other tasks as requested Qualifications Education Graduate of Registered Nursing Program or Registered Practical Nursing Program holding current registration from an accredited School of Nursing. Experience Reimbursement experience 3 years. Experience working in an oncology setting. Understanding of provincial and private coverage criteria and how to navigate the Canadian Drug Coverage Landscape. Familiarity with the Special Authorization process for both public and private insurance in assigned territory. Working knowledge of French language is an asset. Other Skills & Abilities Strong Computer and Technical skills: Excel, Word, Outlook, tablets, web portals/internet use. Established internet and home phone access from home office. Ability to travel; own vehicle required. Primary Location ON-Markham

Location: Markham, Ontario, CA

Posted Date: 11/2/2025