Remote Telehealth RN Case Manager - Care Coordination & Outreach

Archimedes; Trenton (NJ); À distance; USD 70 000 - 90 000; Plein temps

Avantages offerts par ce poste

Health insurance

Dental insurance

Vision insurance

Paid time off - 20 days

Paid parental leave - 4 weeks

Holidays - 9 days

401K with company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Résumé du poste

Archimedes seeks an RN Case Manager for Telehealth to enhance member health through tele-pharmacy, develop outreach programs, and coach members toward adherence and lower-cost formulary options.

The role involves remote engagement with members and prescribers, creation of clinical algorithms and call scripts, and collaboration with staff to maintain high-quality services while following HIPAA regulations. RN licensure and 2+ years of clinical experience are required.

Qualifications

• Associate degree in nursing (ADN) or BSN required; BSN preferred.
• Current, active RN license in good standing with the applicable State Board of Nursing.
• 2+ years of clinical experience including direct consultation.
• Experience in a clinical call center is 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.

Responsabilités

• Develop clinical algorithms, pathways and call scripts to support pharmacy staff in delivering services.
• Review and update all algorithms and call scripts at least yearly and with updated clinical guidelines.
• Develop documentation standards for all clinical outreach.
• Collaborate with department staff to develop and maintain a high quality and consistent product.
• Facilitate communication and education to clients, providers, and internal staff regarding programs and program outcomes.
• Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination.
• Stay current with new guidelines, literature, recommendations, and medications, and integrate that information into clinical programs and outreach efforts to ensure services remain up to date.
• Maintain open lines of communication with other functional areas and departments.
• Develop a full understanding of clients’ member experience and how engagement efforts contribute to improved health and wellness.
• Adhere to compliance and HIPAA regulations.
• Participate in, adhere to, and support compliance, people and culture, and learning programs.
• Perform other duties as assigned.

Connaissances

Clinical experience

Call center experience

Team collaboration

HIPAA compliance

Formation

ADN or BSN degree

Description du poste

Archimedes seeks an RN Case Manager for Telehealth to enhance member health through tele-pharmacy, develop outreach programs, and coach members toward adherence and lower-cost formulary options.

The role involves remote engagement with members and prescribers, creation of clinical algorithms and call scripts, and collaboration with staff to maintain high-quality services while following HIPAA regulations. RN licensure and 2+ years of clinical experience are required.