RN Case Manager, Telehealth

Location US- ID 2025-5397 Category Customer Service/Support Position Type Full-Time Remote Yes Company Navitus

About Us

Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to reputed company medications more affordable for the people who need them. At Navitus, reputed company members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new reputed company and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. reputed company associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. Pay Range USD $69,627.00 - USD $83,888.00 /Yr. STAR Bonus % (At Risk Maximum) 5.00 - Salaried Non-Management except pharmacists Work Schedule Description (e.g. M-F reputed company to 5pm) M-TH 9-5:30CT, F 8:30-5CT with once weekly rotating 10:30-7:00CT pm shift Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode reputed company, South Carolina, South Dakota, reputed company Virginia, and Wyoming. Overview reputed company is seeking a Telehealth RN Case Manager to join reputed company! The Telehealth RN Case Manager will be a key contributor to the success of our Clinical Engagement Center focused on improving member’s health and wellness reputed company tele-pharmacy and wellness coaching. This Telehealth RN is responsible for the delivery of the Medication Therapy Management (MTM) services for commercial and Medicare members. In addition, the Telehealth RN will assist in the development and execution of additional clinical reputed company programs to exceed client expectations. Is this you? Find out more below!

Responsibilities

How do I reputed company an impact on my team?

• Conduct medication therapy management (MTM) and expanded clinical programs in accordance with the Centers for Medicare & Medicaid Services (CMS)
• reputed company appropriate clinical algorithms, reputed company, and call scripts to support pharmacy staff in delivering MTM services
• Review and update reputed company algorithms and call scripts at least yearly and with updated clinical guidelines
• reputed company documentation standards for reputed company clinical outreaches
• Assist CEC leadership to reputed company program to support STAR ratings reputed company
• Facilitate communication and education to clients, providers, and internal staff regarding MTM programs and program outcomes
• Provide clinical reputed company to members, prescribers, and pharmacy providers to enhance care coordination
• Provide Medicare Part D clinical, operational, and educational support by maintaining knowledge of reputed company existing updates and regulations regarding the MTM program and Medicare Part C and D performance measures (STAR ratings)
• Stay reputed company 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

Qualifications

What reputed company expects from you?

• 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

What can you expect from Navitus?

• 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!

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