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Registered Nurse Case Manager

Navitus Health Solutions

Job TitleRN Case Manager, Telehealth (RN)CompanyArchimedesOverviewThe RN Case Manager, Telehealth (RN) will focus on improving members' health and wellness via tele-pharmacy. In addition, the RN will assist in the development and execution of additional clinical outreach program(s) to exceed client expectations. Additional responsibilities will be the provision of telehealth coaching to members in a variety of new program offerings aimed at improving adherence and driving to the lowest net cost formulary options. Remote engagement with members and prescribers will be frequent. The RN will also support department leadership with development of appropriate clinical resources, recommendations regarding targeted medication review selections, and policies and procedures. Other support provided will include clinical oversight of pharmacy technicians, pharmacy interns, and products including reporting and audit support.This role could be located out of our St Louis MO or Brentwood TN offices. We will consider remote associates as well.Is this you? Find out more below!ResponsibilitiesHow do I make an impact on my team?Develop appropriate clinical algorithms, pathways and call scripts to support pharmacy staff in delivering services.Review and update all algorithms and call scripts at least yearly and with updated clinical guidelines.Develop documentation standards for all clinical outreach.Collaborate with department staff to develop and maintain a high quality and consistent product.Facilitate communication and education to clients, providers, and internal staff regarding programs and program outcomes.Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination.Stay current with new guidelines, literature, recommendations, and medications, and integrate that information into clinical programs and outreach efforts to ensure services remain up to date.Maintain open lines of communication with other functional areas and departments.Develop a full understanding of clients' member experience and how engagement efforts contribute to improved health and wellness.Adhere to compliance and HIPAA regulations.Participate in, adhere to, and support compliance, people and culture, and learning programs.Perform other duties as assigned.QualificationsWhat our team expects from you?Education: Associate's degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred.Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.Experience: 2+ years clinical experience including direct consultation experience.Experience in a clinical call center is 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.What can you expect from Archimedes?Top of the industry benefits for Health, Dental, and Vision insurance20 days paid time off4 weeks paid parental leave9 paid holidays401K company match of up to 5% - No vesting requirementAdoption Assistance ProgramFlexible Spending AccountEducational Assistance Plan and Professional Membership assistanceLocationRemoteUS

Vacancy posted 9 hours ago
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