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Home Flexible Job Board Telehealth RN Case Manager - Archimedes

Salary Unstated 121d ago

Telehealth RN Case Manager - Archimedes

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Navitus Health Solutions, LLC

US

Full-time Permanent Remote

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Summary

The RN Case Manager focuses on improving member health and wellness through tele-pharmacy and clinical outreach programs. Responsibilities include developing clinical algorithms, providing coaching to members, and coordinating care with prescribers and pharmacy providers.

Job Description

Company

Archimedes

About Us

Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit – alignment, value and transparency – Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. .____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $0.00 - USD $0.00 /Yr.

STAR Bonus % (At Risk Maximum)

0.00 - Ineligible

Work Schedule Description (e.g. M-F 8am to 5pm)

Monday – Friday 8 – 4:30pm

Remote Work Notification

ATTENTION: Archimedes is unable to offer remote work to residents of Alaska, Arizona, Arkansas, California, Connecticut, Delaware, Hawaii, Idaho, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Montana, Nebraska, Nevada, New Mexico, New York, North Carolina, North Dakota, Oregon, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Washington, West Virginia, And Wyoming.

Overview

The RN Case Manager, Telehealth (RN) will focus on improving members’ health and wellness via tele-pharmacy. In addition, the RN will assist in the development and execution of additional clinical outreach program(s) to exceed client expectations.Additional responsibilities will be the provision of telehealth coaching to members in a variety of new program offerings aimed at improving adherence and driving to the lowest net cost formulary options. Remote engagement with members and prescribers will be frequent. The RN will also support department leadership with development of appropriate clinical resources, recommendations regarding targeted medication review selections, and policies and procedures. Other support provided will include clinical oversight of pharmacy technicians, pharmacy interns, and products including reporting and audit support.

This role could be located out of our St Louis MO or Brentwood TN offices.  We will consider remote associates as well. 

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

  • Develop appropriate clinical algorithms, pathways and call scripts to support pharmacy staff in delivering services.
  • Review and update all algorithms and call scripts at least yearly and with updated clinical guidelines.
  • Develop documentation standards for all clinical outreach.
  • Collaborate with department staff to develop and maintain a high quality and consistent product.
  • Facilitate communication and education to clients, providers, and internal staff regarding programs and program outcomes.
  • Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination.
  • Stay current with new guidelines, literature, recommendations, and medications, and integrate that information into clinical programs and outreach efforts to ensure services remain up to date.
  • Maintain open lines of communication with other functional areas and departments.
  • Develop a full understanding of clients’ member experience and how engagement efforts contribute to improved health and wellness.
  • Adhere to compliance and HIPAA regulations.
  • Participate in, adhere to, and support compliance, people and culture, and learning programs.
  • Perform other duties as assigned.

Qualifications

What our team expects from you?

  • Education: Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred.
  • Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
  • Experience:
    • 2+ years clinical experience including direct consultation experience.
    • Experience in a clinical call center is 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.

What can you expect from Archimedes? 

  • 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 

Location : Address

Remote

Location : Country

US

About the company

Navitus Health Solutions, LLC

Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.

Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.

Founded

2003

Company size

1,001-5,000 employees

Industry

Hospitals and Health Care

Org type

Privately Held

Headquarters

Madison, WI

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About the company

Navitus Health Solutions, LLC

Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.

Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.

Founded

2003

Company size

1,001-5,000 employees

Industry

Hospitals and Health Care

Org type

Privately Held

Headquarters

Madison, WI

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