[Hiring] RN Case Manager, Telehealth @Navitus H...

Role Description 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. • 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 • 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!