Remote Telehealth RN Case Manager for MTM and Wellness

Navitus; Atlanta (GA); Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health, Dental, Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K with 5% match

Adoption assistance

Flexible Spending Account

Educational assistance and membership

Referral bonus up to $750

Job summary

Navitus is seeking a Telehealth RN Case Manager to join its Clinical Engagement Center. The role focuses on delivering Medication Therapy Management (MTM) for commercial and Medicare members and developing additional clinical outreach programs to exceed client expectations.

The position supports CMS guidelines, STAR ratings outreach, and cross-functional collaboration with pharmacy staff, prescribers, and clients. January 2027 or later start is anticipated.

Qualifications

• RN with unrestricted licensure and current registration.
• Minimum 2 years clinical experience, MTM or consult experience preferred.
• Experience in multidisciplinary teams preferred.
• PBM industry knowledge preferred.
• HIPAA and privacy regulations knowledge preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Responsibilities

• Deliver MTM services to commercial and Medicare members.
• Develop clinical algorithms and call scripts for MTM delivery.
• Annual review and update of algorithms and scripts.
• Develop documentation standards for clinical outreaches.
• Support STAR ratings outreach programs.
• Educate clients, providers, and staff regarding MTM programs and outcomes.
• Provide Medicare Part D clinical, operational, and educational support.
• Stay current with guidelines and integrate into MTM programs.
• Perform other duties as assigned.

Skills

RN licensure

Clinical experience

Team collaboration

PBM knowledge

HIPAA knowledge

Compliance awareness

Job description

Navitus is seeking a Telehealth RN Case Manager to join its Clinical Engagement Center. The role focuses on delivering Medication Therapy Management (MTM) for commercial and Medicare members and developing additional clinical outreach programs to exceed client expectations.

The position supports CMS guidelines, STAR ratings outreach, and cross-functional collaboration with pharmacy staff, prescribers, and clients. January 2027 or later start is anticipated.