Up to 3 year(s)
Under the direction of a District Manager, the Field Case Manager for the Program is responsible for managing all aspects of the program for assigned physicians in a given geographical area or hospital. The individual will work directly with the physicians and or the office staff to provide proactive and seamless services with respect to the program by accessing the ongoing needs of each MD/office such that the service levels provide a clear differentiating factor between this Program and other patients’ support programs.
The resulting objective of this superior and proactive service will be to increase the patient program enrollment and improved patient outcomes. Knowledge in regional government payer policies, private payer policies and procedures is required. Regular travel to various HCP offices is a primary responsibility of the role. The FCM typically oversees large accounts inclusive of University settings and may cover rural and tertiary health centers as needed.
PRIMARY DUTIES AND RESPONSIBILITIES:
- Be the single point of contact for the program with physicians
- Assist MDs in completing Special Authorization (SA) forms, enrolment forms, prescription renewals, and other documentation
- Provide ongoing updates to MDs on patient status
- Provide therapy guidelines to manage physician expectations with respect to reimbursement
- Work collaboratively with Personal Care Specialists, Wellness Case managers and Sales representatives
- Provide program service explanation to MDs and/or Office staff
- Promote the program with the marketing tools provided
- Customize current program elements to meet the needs of assigned physicians: adjust based on in clinic and remote MD needs.
- Work in the field and perform regular services calls with MD and/or Office staff
- Consult patient charts in order to effectively complete necessary paperwork to obtain coverage
- Follow up with MD to insure patient status updates are shared
- Responsible for providing customized monthly reports to physicians
- Accurate and timely patient charting in CRM
- Participate in scheduled physician meetings with Sales representatives
- Attends scheduled Continuous Medical Education events and reports new activities;
- Identify areas for risk and foster proactive, continued quality improvement.
- Proactively provides assistance to resolve client issues with regards to assigned physicians;
- Provides in service presentation to physicians
- Adhoc duties as assigned
- Registered nurse (RN) or Registered Practical Nurse (RPN)
- Two (2) to three (3) years in public or private third party reimbursement arena or pharmaceutical sales experience, managed care, or clinical support, or related experience is preferred
- Previous Case Manager experience an asset
- Basic CCPE an asset
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
- Superior customer service skills
- Demonstrated teamwork abilities
- Ability to manage multiple tasks and priorities at once
- Comprehension of medical terminology, Ability to read and interpret patient charts
- Strong analytical skills including interpretation of regulation and legislation.
- Ability to make decisions using sound judgment
- Ability to work autonomously
- Strong organizational skills, creative problem solving and results oriented.
- Strong time and project management skills and sense of urgency
- Ability to analyze current enrollment volume by MD
- Ability to analyze enrollment potential based on prescription volume of other biologics
- Ability to engage with a physician and his/her staff as a trusted and well-informed medical counterpart
- Must have a valid driver’s license and possess a car
- Ability to attend Continuous Healthcare Education (CHE) events with HCPs, which may occur outside regular business hours
- Can interact with multiple sales reps and district managers from the commercial team
- Superior verbal and written communication skills, interpersonal skills and attention to detail
- Strong ability to communicate effectively both verbally and in writing
- Established relationships with Customers in a given territory, an asset
- Knowledge of public, private and federal reimbursement an asset
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