Remote Telehealth RN Case Manager — MTM & Care Coordination

Navitus; Helena (MT); À distance; USD 80 000 - 100 000; Plein temps

Avantages offerts par ce poste

Health insurance

PTO 20 days

Parental leave 4 weeks

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Professional Membership assistance

Referral Bonus Program – up to $750!

Résumé du poste

Navitus Health Solutions is expanding its Telehealth RN Case Manager role to deliver MTM services for commercial and Medicare members via tele-pharmacy and wellness coaching. The position supports CMS MTM program delivery and STAR ratings outreach, with development of clinical scripts and documentation standards.

The Telehealth RN will collaborate with a multidisciplinary team to stay current with guidelines and regulations, targeting improved member health outcomes and engagement.

Qualifications

• Registered nurse with unrestricted licensure.
• Two years clinical experience including direct consultation 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 is preferred.
• Knowledge of healthcare industry practices and HIPAA regulations.
• Participate in, adhere to, and support compliance program objectives.
• Ability to interact cooperatively and respectfully with other employees.

Responsabilités

• Perform MTM and expanded clinical programs per CMS.
• Develop clinical algorithms, pathways, and call scripts to support MTM delivery.
• Review/update algorithms and scripts yearly with updated guidelines.
• Develop documentation standards for all clinical outreaches.
• Assist leadership to develop programs to support STAR ratings outreach.
• Communicate education to clients, providers, and internal staff regarding MTM outcomes.
• Provide Medicare Part D clinical, operational, and educational support.
• Stay current with guidelines and integrate updates into MTM and STAR programs.
• Other duties as assigned.

Connaissances

Registered Nurse

Clinical experience

Multidisciplinary teamwork

Description du poste

Navitus Health Solutions is expanding its Telehealth RN Case Manager role to deliver MTM services for commercial and Medicare members via tele-pharmacy and wellness coaching. The position supports CMS MTM program delivery and STAR ratings outreach, with development of clinical scripts and documentation standards.

The Telehealth RN will collaborate with a multidisciplinary team to stay current with guidelines and regulations, targeting improved member health outcomes and engagement.