Remote RN Case Manager, Telehealth MTM & Wellness

Navitus; Montgomery (AL); À distance; USD 75 000 - 110 000; Plein temps

Avantages offerts par ce poste

Health, dental and vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption assistance

Flexible Spending Account

Educational assistance and membership

Referral bonus up to $750

Résumé du poste

Navitus Health Solutions seeks a Telehealth RN Case Manager to deliver MTM services for commercial and Medicare members. You will help develop outreach programs, collaborate with the Clinical Engagement Center, and enhance care coordination through clinical telehealth support.

The role emphasizes staying current with CMS updates, building standardized outreach, and supporting STAR ratings initiatives while providing education to clients and providers.

Qualifications

• Unrestricted RN licensure.
• Two years clinical experience including direct consultation preferred.
• Experience in multi-disciplinary teams preferred.
• Professional PBM industry experience preferred.
• Knowledge of HIPAA regulations and healthcare privacy practices preferred.
• Ability to interact cooperatively with colleagues and staff.

Responsabilités

• Deliver MTM services and expanded clinical programs per CMS guidance.
• Develop algorithms, pathways, and call scripts to support MTM delivery.
• Review and update MTM materials annually with new guidelines.
• Create documentation standards for clinical outreach initiatives.
• Support STAR ratings outreach with CEC leadership.
• Educate clients, providers, and staff about MTM programs and outcomes.
• Provide Medicare Part D/Part C guidance and stay current with updates.

Connaissances

RN licensure

Clinical experience

Team collaboration

HIPAA knowledge

Formation

RN license

Description du poste

Navitus Health Solutions seeks a Telehealth RN Case Manager to deliver MTM services for commercial and Medicare members. You will help develop outreach programs, collaborate with the Clinical Engagement Center, and enhance care coordination through clinical telehealth support.

The role emphasizes staying current with CMS updates, building standardized outreach, and supporting STAR ratings initiatives while providing education to clients and providers.