RN Case Manager, Telehealth
Navitus Health Solutions
full-time
Posted on:
Location Type: Remote
Location: Remote • Idaho • 🇺🇸 United States
Visit company websiteSalary
💰 $69,627 - $83,888 per year
Job Level
JuniorMid-Level
About the role
- Conduct medication therapy management (MTM) and expanded clinical programs in accordance with the Centers for Medicare & Medicaid Services (CMS)
- Develop appropriate clinical algorithms, pathways, and call scripts to support pharmacy staff in delivering MTM services
- Review and update all algorithms and call scripts at least yearly and with updated clinical guidelines
- Develop documentation standards for all clinical outreaches
- Assist CEC leadership to develop program to support STAR ratings outreach
- Facilitate communication and education to clients, providers, and internal staff regarding MTM programs and program outcomes
- Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination
- Provide Medicare Part D clinical, operational, and educational support by maintaining knowledge of all existing updates and regulations regarding the MTM program and Medicare Part C and D performance measures (STAR ratings)
- Stay current with new guidelines, literature, recommendations, and medications, and integrate that information into the MTM and STARs programs, such that our clinical outreaches remain up to date
- Other duties as assigned
Requirements
- Registered Nurse with unrestricted licensure
- Two years clinical experience including direct consultation experience preferred
- Experience as a member of a multi-disciplinary team is preferred
- Professional PBM industry work experience is preferred
- Knowledge of applicable data privacy practices and laws is preferred
- Knowledge of healthcare industry practices and HIPAA regulations
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
Benefits
- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medication therapy managementclinical algorithmscall scriptsdocumentation standardsclinical outreachMedicare Part Doperational supportSTAR ratingscare coordinationdata privacy practices
Soft skills
communicationeducationcooperationrespectfulnessteam collaborationleadershipinterpersonal skillsorganizational skillsconsultationadaptability
Certifications
Registered Nurseunrestricted licensure