Join our dynamic team dedicated to improving member health and wellness through tele-pharmacy and wellness coaching. We prioritize high-quality care and offer a supportive work-life balance uncommon in nursing roles.
Job Overview
As a Telehealth RN Case Manager, you will play a crucial role in our Clinical Engagement Center (CEC), delivering Medication Therapy Management (MTM) services to commercial and Medicare members. You'll engage members via telephonic or video chat to assess their medication regimens and collaborate on personalized Medication Action Plans.
Key Responsibilities
Conduct medication therapy management (MTM) and expand clinical programs in alignment with CMS guidelines.
Develop clinical algorithms, pathways, and call scripts to enhance pharmacy staff delivery of MTM services.
Update clinical guidelines, call scripts, and documentation standards regularly.
Collaborate across CEC teams to maintain high-quality MTM services and exceed client expectations.
Support STAR ratings outreach initiatives led by CEC leadership.
Educate clients, providers, and internal teams on MTM programs and outcomes.
Provide clinical outreach to members, prescribers, and pharmacy providers for improved care coordination.
Stay updated on new guidelines, literature, and medications to ensure MTM programs remain current.
Qualifications
Registered Nurse with unrestricted licensure.
Minimum two years of clinical experience, including direct consultation preferred.
Experience in multidisciplinary teams and professional PBM industry work is advantageous.
Knowledge of HIPAA regulations and healthcare industry practices.
Commitment to compliance and teamwork in a cooperative work environment.
Paid Volunteer Hours, Educational Assistance, and Professional Membership support.
Referral Bonus Program (up to $750!).
Comprehensive benefits: Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Nine paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program.
Is This You?
If you're ready to leverage your nursing experience to make a meaningful impact while enjoying a supportive work environment, apply now to join our team!
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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