Remote Telehealth RN Care Navigator

Archimedes; Frankfort (KY); Hybrid; USD 85,000 - 125,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

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. D

Job summary

Navitus Health Solutions is seeking an RN Case Manager, Telehealth to enhance member health through tele-pharmacy and clinical outreach programs. You will develop algorithms, support staff, and coordinate care with prescribers while staying current with guidelines.

The role can be based in St. Louis, MO or Brentwood, TN, or work remotely. Requires ADN/BSN and an active RN license, plus at least 2 years of clinical experience; PBM and HIPAA knowledge are preferred.

Qualifications

• Associate’s or Bachelor’s degree in nursing required; BSN preferred.
• Current active RN license in good standing.
• Minimum 2 years of clinical experience including direct consultation.
• Experience in a clinical call center is preferred.
• Experience as part of a multi-disciplinary team is preferred.
• Professional PBM industry work experience is preferred.
• Knowledge of data privacy practices and HIPAA regulations is preferred.

Responsibilities

• Develop clinical algorithms, pathways and call scripts to support staff.
• Review and update algorithms and call scripts yearly with updated guidelines.
• Develop documentation standards for all clinical outreach.
• Collaborate with staff to maintain high quality and consistency.
• Facilitate communication with clients, providers, and internal staff.
• Provide clinical outreach to members, prescribers, and providers.
• Stay current with guidelines and medications and integrate into programs.
• Maintain open lines of communication with other departments.
• Understand member experience and engagement impact on health.
• Adhere to compliance and HIPAA regulations.
• Participate in compliance, people and culture, and learning programs.
• Perform other duties as assigned.

Skills

Clinical experience

Call center experience

Team collaboration

HIPAA knowledge

Education

Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred.

Tools

PBM systems

Job description

Navitus Health Solutions is seeking an RN Case Manager, Telehealth to enhance member health through tele-pharmacy and clinical outreach programs. You will develop algorithms, support staff, and coordinate care with prescribers while staying current with guidelines.

The role can be based in St. Louis, MO or Brentwood, TN, or work remotely. Requires ADN/BSN and an active RN license, plus at least 2 years of clinical experience; PBM and HIPAA knowledge are preferred.