Remote RN Case Manager, Telehealth MTM and Outreach

Navitus; Lansing (MI); Remote; USD 85.000 - 110.000; Vollzeit

Benefits dieser Stelle

Health/dental/vision

Paid time off

Parental leave

Paid holidays

401K match

Adoption assistance

FSAs

Educational assistance

Referral bonus

Zusammenfassung

Navitus Health Solutions is expanding its Telehealth RN Case Manager role to improve member health and wellness through tele-pharmacy and wellness coaching. You will deliver MTM services for commercial and Medicare members and help develop and execute additional clinical outreach programs to meet client expectations.

The position requires RN licensure, clinical experience and teamwork, with responsibilities spanning MTM delivery, program development, and adherence to CMS guidelines.

Qualifikationen

• Registered Nurse with unrestricted licensure.
• Two years clinical experience including direct consultation preferred.
• Experience as a member of a multi-disciplinary team is preferred.
• Professional PBM industry work experience is preferred.
• Knowledge of data privacy practices and HIPAA regulations preferred.
• Knowledge of healthcare industry practices and HIPAA regulations.

Aufgaben

• Conduct MTM and expanded clinical programs per CMS.
• Develop clinical algorithms, pathways, and call scripts for MTM.
• Review and update algorithms and scripts annually with new guidelines.
• Develop documentation standards for all clinical outreaches.
• Assist leadership to develop STAR ratings outreach programs.
• Communicate MTM program outcomes to clients, providers, and staff.
• Provide Medicare Part D clinical, operational, and educational support.

Kenntnisse

RN licensure

Clinical experience

Multi-disciplinary teamwork

PBM industry experience

HIPAA knowledge

Healthcare knowledge

Compliance participation

Team communication

Jobbeschreibung

Navitus Health Solutions is expanding its Telehealth RN Case Manager role to improve member health and wellness through tele-pharmacy and wellness coaching. You will deliver MTM services for commercial and Medicare members and help develop and execute additional clinical outreach programs to meet client expectations.

The position requires RN licensure, clinical experience and teamwork, with responsibilities spanning MTM delivery, program development, and adherence to CMS guidelines.