Remote RN Telehealth Case Manager — MTM Specialist

Navitus; Lincoln (NE); Remote; USD 80,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro/MX

Referral Bonus Program – up to $750

Job summary

Navitus Health Solutions is expanding its Telehealth RN Case Manager team to deliver Medication Therapy Management (MTM) and wellness outreach to commercial and Medicare members via telehealth.

The role supports CMS guidelines, develops MTM pathways, and collaborates with pharmacy staff to optimize patient care. January 2027 or later start; remote work options available; join a growing Clinical Engagement Center.

Qualifications

• RN with unrestricted licensure.
• Two years clinical experience including direct consultation preferred.
• Experience in a multi-disciplinary team is preferred.
• PBM industry experience preferred.
• Knowledge of data privacy practices and HIPAA regulations.

Responsibilities

• Conduct MTM and expanded clinical programs per CMS guidelines.
• Develop clinical algorithms, pathways, and call scripts for MTM delivery.
• Review and update MTM algorithms and scripts annually with guidelines.
• Develop documentation standards for clinical outreaches.
• Support STAR ratings outreach programs and leadership development.
• Educate clients, providers, and staff about MTM programs and outcomes.
• Provide Medicare Part D clinical, operational, and educational support and stay updated on regulations.
• Stay current with new guidelines and literature to keep MTM and STAR programs updated.
• Perform other duties as assigned.

Skills

Registered Nurse

Clinical experience

Team collaboration

HIPAA knowledge

Communication skills

Education

RN licensure (unrestricted)

Job description

Navitus Health Solutions is expanding its Telehealth RN Case Manager team to deliver Medication Therapy Management (MTM) and wellness outreach to commercial and Medicare members via telehealth.

The role supports CMS guidelines, develops MTM pathways, and collaborates with pharmacy staff to optimize patient care. January 2027 or later start; remote work options available; join a growing Clinical Engagement Center.