Remote Telehealth RN Case Manager – MTM & Care Coordination

Navitus; Indianapolis (IN); Remote; USD 85,000 - 100,000; 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 company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Member

Referral Bonus Program – up to $750!

Job summary

Navitus Health Solutions is expanding its Telehealth RN Case Manager team in the United States. This role focuses on delivering Medication Therapy Management (MTM) services for commercial and Medicare members via telehealth, and supporting additional clinical outreach programs to enhance client outcomes.

The Telehealth RN Case Manager will develop and implement MTM algorithms, review program materials annually, and collaborate with pharmacy staff and leadership to improve STAR ratings and

Qualifications

• RN with unrestricted licensure
• Two years clinical experience including direct consultation preferred
• Experience in a multi-disciplinary team is preferred
• Professional PBM industry experience is preferred
• Knowledge of data privacy practices and HIPAA regulations preferred
• Knowledge of healthcare industry practices and HIPAA regulations
• Ability to comply with and support compliance objectives
• Ability to interact cooperatively and respectfully with others

Responsibilities

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

Skills

RN licensure

Clinical experience

Multidisciplinary team

HIPAA knowledge

PBM industry knowledge (preferred)

Communication

Program development

Job description

Navitus Health Solutions is expanding its Telehealth RN Case Manager team in the United States. This role focuses on delivering Medication Therapy Management (MTM) services for commercial and Medicare members via telehealth, and supporting additional clinical outreach programs to enhance client outcomes.

The Telehealth RN Case Manager will develop and implement MTM algorithms, review program materials annually, and collaborate with pharmacy staff and leadership to improve STAR ratings and