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Bayshore

Nurse Case Manager

Mississauga, ON, Canada

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Job details

Experience: Minimum 2 years’ experience in Patient Support Programs or equivalent.
Posting language: English
Posted: Nov 2, 2026

Original job description

JOB SUMMARY

The Nurse Case Manager (NCM) will play an essential role in supporting patients living with HIV disease to improve both their health outcomes and quality of life. NCM offers enrolment and reimbursement support to physicians and 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 key resource to physicians who are prescribing this medication and continuous support for renewals, and coverage changes. NCM will also supervise the coordination of monthly injection.

DUTIES AND RESPONSIBILITIES

Assist in completing patient enrolment; including gathering all pertinent and appropriate information 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.
Ensure patients are scheduled for necessary diagnostic tests and notify physicians of any expired test results that require follow-ups.
Complete Welcome Call activities with the patient according to defined scripts.
Provide patients and physicians with direct toll-free number.
Review post visit reports to confirm next appointment is scheduled and data integrity of the report against the physician order, if applicable.
Track missing post visit reports, if applicable.
Facilitate any required communication with physicians, Patient Support Programs, or other health care professionals involved in the patient’s circle of care.
Follow up and advocate until a decision is received, ideally securing coverage for the patient, if applicable.
Work closely with the manufacturer local sales representatives to support specific physician’s and staff needs, if applicable.
Offer and/or provide educational training to patients and physicians on product(s).
Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics.
Coordinate and schedule patients at appropriate visit locations (home, clinic, etc.), if applicable.
Provide updates to internal and external stakeholders based on observations.
Ensure patient records are maintained and data-accurate to meet program reporting requirements.
Must be able to identify and report Adverse Events to Health Canada, Med Info, and enter into source system and third-party systems.
Report and document Adverse Events as per Pharmacovigilance requirements.
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.
Maintain confidentiality of pharmaceutical partner(s) and corporate information and discuss same only with appropriate Bayshore personnel.
Complete all relevant reports (time sheets, expenses, mileage, reports, etc.) as per specified timelines and Bayshore’s policy, if applicable.
Complete product complaint reports.
Adhere to Bayshore and manufacturer Policies and Procedures.
Complete other tasks, as requested.

QUALIFICATIONS

Education

Graduate of registered Nursing Program or registered practical nursing program holding current registration from a provincial licensing body in Canada.

Experience

Registered and in good standing with their provincial regulatory body.
Minimum 2 years’ experience in Patient Support Programs or equivalent.
Demonstrated expertise in delivering exceptional customer service and fostering positive relationships with internal and external stakeholders.
This position requires bilingual proficiency in French and English (spoken and written) due to operational, client, and regulatory requirements.
Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset.
Strong computer and technical skills: Excel, Word, Outlook, tablets, web portals/internet use.
Strong critical thinking and problem-solving skills.
Making decisions using sound judgment.
Proficient with accurate data collection and data integrity.
Ease with working in a paperless environment.
Ability to drive for results.
Proven ability to work in a team environment.
Ability to resolve conflict in a professional matter.
Strong sense of organization and attention to detail.
Self-regulation of time management and the ability to multi-task and adhere to deadlines.
Familiarity with PIPEDA and how it applies in a confidential patient environment.
Ability to work in a quiet working environment with proven ability to work autonomously within a remote/virtual team environment.
Established high speed internet access from home office.

At Bayshore Healthcare, our commitment to Equity, Diversity & Inclusion is our strength. This is how we bring our vision of being the difference in the lives of those we care for, work with and in our communities. We have a great sense of pride in creating a culture of belonging, where individual differences are embraced and celebrated, through programs, resources and policies that support each individual's purpose, potential and wellbeing.

At Bayshore Healthcare Ltd., and its subsidiaries, we are committed to fostering an inclusive workplace and operate in full compliance with all Provincial and Territorial legislation pertaining to Human Rights Codes and Accessibility requirements. To ensure continued compliance throughout the recruitment and selection process, we encourage candidates to disclose any accommodation needs they may have.

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More about this job

Responsibilities

Support patients living with HIV by coordinating enrollment, drug reimbursement and coverage, diagnostic testing, appointments, and ongoing communication with physicians and other care stakeholders. Maintain accurate patient records, report adverse events and product complaints, and provide education and program support in accordance with quality, privacy, and pharmacovigilance requirements.

Requirements

Requires graduation from a registered nursing or practical nursing program, current registration in good standing with a Canadian provincial regulator, and at least two years of Patient Support Program or equivalent experience. French and English proficiency, knowledge of Canadian drug coverage processes, strong computer and organizational skills, and the ability to work independently in a remote or virtual team environment are also required.

Skills

Patient Case Management
Patient Support Programs
Nursing
Patient Enrollment
Drug Reimbursement and Coverage
Insurance Navigation
Patient Advocacy
Care Coordination
Adverse Event Reporting
Pharmacovigilance
Data Integrity
Customer Service
Critical Thinking
Problem-Solving
Time Management
Confidentiality and PIPEDA Compliance

Visa sponsorship

Not detected in the job text

Keywords

HIV
Nurse Case Manager
Registered Nurse
Registered Practical Nurse
Patient Support Programs
Patient Enrollment
Private Drug Formularies
Provincial Drug Formularies
Drug Reimbursement
Special Authorization
Third-Party Providers
Patient Advocacy
Care Coordination
Diagnostic Testing
Adverse Events
Health Canada
Pharmacovigilance
Product Complaints
Patient Records
Data Integrity
Quality Management System
PIPEDA
Excel
Word
Outlook
Web Portals
French-English Bilingual Proficiency
Patient Education
Confidentiality

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