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Field Case Manager (RN) - Orleans in Ottawa at Innomar Strategies

Date Posted: 3/16/2018

Job Snapshot

  • Employee Type:
  • Location:
  • Job Type:
  • Experience:
    3 to 5 years
  • Date Posted:

Job Description

*15 Month Contract*


Reporting to the Program Manager, Specialty Services, the Field Case Manager (FCM) is responsible for managing all aspects of the reimbursement environment and program support for assigned physicians and their respective patients in a given geographical area. An expert in regional government payer policies and procedures, the FBCC supports the regional needs of the client and works directly with in house team to facilitate the enrolment, reimbursement and scheduling process to ensure patients have easy access to their prescribed therapy. The individual also assists the physicians in assessing the needs of each patient resulting in increased patient program enrolment and improved patient outcomes.


Practice Management

  • Customizes program elements to meet the needs of assigned prescribing physicians;
  • Reviews patient status and assists the prescribing physician to complete patient enrolment, prepare Special Authorization (SA) petitions for public or private coverage by reviewing patient charts, assessing previous therapies and tests in order to complete the SA;
  • Provides regular updates to Health Care Providers (HCP’s) on patient therapy status (e.g.: enrolment, reimbursement and adherence).
  • Assists Physician’s with patients’ lab-test reminders (if applicable) in order to expedite access to therapy.

Patient Support

  • Welcomes each patient to the program (conducts Welcome/Enrolment Call) and captures required patient information;
  • Provides therapy information, education and motivation to patients as a support to their HCP’s;
  • Ensures patient services are coordinated and tracked, according to KPI’s, in a timely manner resulting in quick and continued access to therapy;
  • Coordinates all aspects of public coverage activity directly with the provincial formularies and provides support by gathering relevant information for private plans following program Standard Operating Procedures (SOPs);
  • Follow up with patient the outcome of reimbursement navigation;
  • Proactively communicates with patients and HCP’s to facilitate prescription renewals in a timely fashion;
  • Follows up with each assigned patient to confirm reimbursement status and readiness to begin therapy;
  • Assists patients with coordination of drug delivery (where applicable) and provides regular adherence education and guidance;
  • Reports Adverse Events / Severe Adverse Events (AE / SAEs) following approved SOP’s.

Mentorship/Peer Support

  • Assists in training and development of new Field-Base Care Coach as needed;
  • Supports and assists peers through regular and ongoing communication.

Client Interface

  • Participates in scheduled KOL physician meetings with Pharmaceutical Representatives;
  • Provides in service presentation to KOL physicians in collaboration with the Pharmaceutical Representatives on new program initiatives;
  • Participates in regularly scheduled and ad-hoc meetings with client and team;
  • Proactively provides assistance to resolve client issues with regards to assigned physicians;
  • Provides guidance on individual physician and clinic environments/needs so that services can be tailored to maximize patient enrolment and physician satisfaction.

Program Management and Communication

  • Provides assistance to other program staff to expedite patient’s access to therapy.
  • Updates the patient files by providing timely patient and HCP information.
  • Fosters and promotes a spirit of teamwork while working with internal support teams.
  • Develops and maintains a positive relationship with the Program Patient Support team.


  • Acts a liaison and provides ongoing feedback to their Supervisor based on observations in the field and feedback from customers as it pertains to quality of services, training, and other areas of importance.
  • Performs ongoing monitoring of program-related activities and work allocation
  • Identifies obstacles to obtaining coverage and channels this information to the Program Manager.

Continuous Education

  • Attends scheduled Continuous Medical Education (CME) sessions and regional payer and practice management meetings and reports new activities.
  • Proactively assesses programs and makes suggestions to enhance outcomes and quality of service.

Job Requirements


  • Registered nurse (RN) diploma- License to practice with the OIIQ
  • Normally requires a minimum of three (3) to five (5) years in public or private third party reimbursement arena or pharmaceutical industry in sales, managed care, or clinical support, or related experience;
  • Knowledge of private and public reimbursement structure, systems, and process;
  • Experience with reimbursement billing, special access, appeals process and conducting field-based reimbursement support and consultation;
  • 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 Rheumatology is an asset;


  • Strong analytical skills including interpretation of regulation and legislation;
  • Ability to make decisions using sound judgment;
  • Strong coaching and training skills;
  • Excellent active listening skills;
  • Customer-focused and patient-centric in orientation superior verbal and written communication skills, and attention to detail;
  • Ability to quickly establish rapport with a variety of personalities;
  • Demonstrated ability to work effectively both autonomously and in teams;
  • Ability to handle and manage multiple responsibilities and tasks;
  • Strong organizational skills, creative problem solving and results-oriented;
  • Strong computer skills; Knowledge of Microsoft Word, Excel, PowerPoint and other Office Programs
  • Bilingual English/ French required
  • Ability to consistently meet deadlines
  • Excellent presentation skills
  • Completes all relevant reports (time sheets, expenses, mileage, validate reports, etc.) as per specified timelines and as per required standards.