Registered Nurse, Telehealth

Navitus Health Solutions; United States; Remote; USD 72,000 - 86,000; Full time

Job summary

Navitus Health Solutions is expanding its Telehealth Registered Nurse team. The RN, Telehealth conducts telephonic comprehensive medication reviews and consultations to improve patient adherence and support CMS/HIPAA regulations, collaborating with providers, clinics, and pharmacies.

The role focuses on resolving medication concerns, coordinating care transitions, and delivering evidence-based recommendations.

Qualifications

• RN with multi-state compact license in state of residence.
• 3 years of clinical experience including direct consultation.
• Willingness to obtain additional state licensure.
• Experience in multidisciplinary teams preferred.
• PBM knowledge a plus.

Responsibilities

• Independently conduct telephonic comprehensive medication reviews (CMRs) per CMS, HIPAA compliant.
• Educate members on program benefits and medication adherence within protocols.
• Provide optimal care through evidence-based clinical recommendations.
• Perform routine telephonic medication consultations to address adherence and gaps.
• Collaborate with providers, clinics, and pharmacies to resolve concerns.

Skills

Clinical experience

Interdisciplinary collaboration

Patient education

Education

High school diploma or GED

BSN preferred

Job description

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 make medications more affordable for the people who need them.

At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other. Current associates must use SSO login option at 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 $71,716.18 - USD $86,405.04 /Yr. STAR Bonus % (At Risk Maximum) 7.50 - Salaried Non-Management except pharmacists.

Work Schedule Description (e.g. M-F 8am to 5pm) M-Th 9am-5:30pm CT with 1 rotating shift of 10:30am-7pm CT & Fri 8:30am-5pm CT.

Remote Work Notification ATTENTION: Navitus is only able to offer remote work to residents of Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington DC, Wisconsin.

Overview The expected start timeframe for this position is January 2027 or later. Our team is growing! We're excited to be expanding our team with a new Telehealth Registered Nurse position. If you're ready for a new challenge and an opportunity to use your nursing skills in a different way.

The Registered Nurse, Telehealth is part of the Clinical Engagement Center (CEC) and conducts telephonic comprehensive medication reviews and consultations to improve patient adherence, close therapy gaps, and support clinical initiatives, all while ensuring compliance with CMS and HIPAA regulations. The Registered Nurse, Telehealth will also collaborate with healthcare providers, clinics, and pharmacies to resolve patient concerns and enhance care coordination. Additionally, the Registered Nurse, Telehealth will stay current with regulatory updates and clinical guidelines.

Responsibilities

• Independently conduct routine telephonic comprehensive medication reviews (CMRs) in accordance with the Centers for Medicare & Medicaid Services (CMS), ensuring compliance with HIPAA and other regulatory standards.
• Educate members on program benefits and medication adherence applying routine clinical judgment within program protocols to identify risks, address, barriers and determine appropriate interventions.
• Provide optimal care through the delivery of evidence-based clinical recommendations to support improved health outcomes.
• Perform routine telephonic medication consultations to address member adherence, close therapy gaps, and assist with other clinical initiatives.
• Assess and interpret member needs to recommend appropriate clinical interventions.
• Ability to apply sound clinical judgment in well-defined situations and determine appropriate actions while escalating when non- routine situations when appropriate.
• Support members during transitions of care, including routine Personalized Member Transitions (PMT), by discussing alternative medications and coverage changes.
• Collaborate with team members to maintain consistent, high-quality clinical services.
• Stay informed on clinical program requirements and procedures to ensure compliance and quality.
• Conduct telephonic clinical outreach to members, prescribers, and pharmacies address patient concerns and enhance care coordination.
• Coordinate with providers, clinics, pharmacies, and members to resolve medication-related concerns and promote continuity of care.
• Maintain current knowledge of clinical practice guidelines, medications, and best practices to deliver accurate and effective recommendations.
• Identify and address barriers to medication access, providing guidance on benefits and available resources.
• Other duties as assigned.

Qualifications

• High school diploma or GED required.
• BSN preferred.
• Current, unrestricted Registered Nurse multi-state compact license in the state of residence required.
• Willingness and ability to obtain additional state licensure where applicable.
• 3 years of clinical experience including direct consultation experience required.
• Experience as a member of a multi-disciplinary team preferred.
• Professional PBM