Clinical Case Management Associate

Job Description

Job Description

JOB SUMMARY & RESPONSABILITIES:

The Clinical Case Management Associate is responsible for performing telephonic and face to face contact with patients of Alivia Specialty Pharmacy. He or she will evaluate the health care and educational needs of the patients regarding medications and will communicate recommendations to prescribers as necessary. Among other duties, the Clinical Case Management Associate will ensure patient’s understanding of medication regimens and will recognize and provide next steps for patients reporting adverse reactions or concerns with specialty medications. From time to time, the Clinical Case Management Associate may be required to conduct some field work to visit HCP’s and Patients or to accompany Management in carrying out some work-related activities.

Responsibilities include, but are not limited to the following:

• Assesses, monitors and evaluates medication care plans, services and outcomes to maximize patient’s health/outcomes.
• Identifies patient's health and educational needs.
• Communicates with providers regarding patient's medication complications or needs.
• Provides guidance to patients on adverse medication reactions within scope and refers to pharmacist as necessary.
• Completes REMS product training and provides counseling for patients on subsequent cycles of available REMS products.
• Provides medication counseling for patients starting new medication regimens.
• Interacts continuously with patient, family, physician(s), and other providers utilizing clinical knowledge and expertise to determine medical history and current status.
• Reports critical incidents and information regarding quality-of-care issues.
• Assist Operations/Clinical Department associates with clinical support for prior authorization, billing or other administrative functions, during periods of high volume, to maintain workflow and meet customer service imperatives.
• Provide support as on-call clinician as required.
• Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.
• Performs other duties as assigned.

Education and Experience:

• Bachelor’s Degree in Nursing.
• Current/Active Professional Certification/License in Good Standing.
• 3 years of experience in patient nursing and/or direct patient care. (preferred)
• 2 years of experience in Specialty Pharmacy. (preferred)
• Knowledge of CPR+. (preferred)
• Knowledge and experience in the areas of Neurology /Multiple sclerosis, Rheumatology, Dermatology, Gastroenterology, Infectious Disease, Asthma, Oncology, or Pediatrics. (preferred)
• Ability to communicate effectively in English and Spanish. (preferred)

***EEOC F/M/D/V***