Emphasizing People-Centric Care in Pharmacy: We are an innovative healthcare organization dedicated to revolutionizing the traditional pharmacy benefit manager (PBM) model. Our mission is to streamline the drug supply chain, ensuring that essential medications are accessible and affordable for all. At our company, diversity is celebrated, creativity is nurtured, and personal growth is encouraged. We cultivate an environment where fresh ideas flourish and where exceptional service to our clients and colleagues is paramount.
Please note that remote work is not available for residents of specific states.
Are you a nurse seeking a change from night shifts, holidays, and weekends? Are you eager to leverage your nursing expertise to positively impact lives while enjoying a better work-life balance? Join our dynamic team, whether you prefer a fully remote setup or an office presence in Appleton (WI), Madison (WI), Phoenix (AZ), or Austin (TX).
As a Telehealth RN Case Manager, you will play a pivotal role in our Clinical Engagement Center, focusing on enhancing member health and wellness through tele-pharmacy and wellness coaching. Your responsibilities will include delivering Medication Therapy Management (MTM) services to commercial and Medicare members. Additionally, you'll contribute to the development and implementation of innovative clinical outreach initiatives, surpassing client expectations.
The MTM program involves conducting telephonic or video chat sessions with members to analyze their medication regimens. You'll collaborate with members to create personalized Medication Action Plans, aligning with Centers for Medicare and Medicaid Services (CMS) requirements.
Key Responsibilities
Does this opportunity align with your career aspirations? Read on to learn more about how you can make a difference within our team:
Conduct MTM and expanded clinical programs in adherence with CMS guidelines.
Develop clinical algorithms, pathways, and call scripts to support pharmacy staff in delivering MTM services.
Collaborate with team members to maintain high-quality MTM services and exceed program expectations.
Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination.
Stay updated on industry guidelines, literature, recommendations, and medications to ensure program relevance and effectiveness.
Qualifications
Registered Nurse with an unrestricted license.
Two years of clinical experience, with direct consultation experience preferred.
Experience working within a multidisciplinary team is advantageous.
Familiarity with PBM industry practices and healthcare regulations is beneficial.
Commitment to compliance and professionalism in all interactions.
What We Offer
Flexible work hours: Monday-Thursday 10:30am-7:00pm CST, Friday 8:30am-5:00pm CST (Remote)
Paid Volunteer Hours
Educational Assistance Plan and Professional Membership Support
Referral Bonus Program (up to $750!)
Comprehensive Health, Dental, and Vision Insurance
Flexible Spending Account
Generous Paid Time Off, including Nine Paid Holidays
401K Retirement Plan
Short-term and Long-term Disability Coverage
College Savings Plan, Paid Parental Leave, Adoption Assistance Program
Employee Assistance Program for Well-being Support
Join us in making a meaningful impact on healthcare delivery while enjoying a supportive and rewarding work environment.
Employment Type: Full-Time
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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