Remote Telehealth RN Case Manager — MTM & Medicare

Navitus; Little Rock (AR); Remote; USD 85.000 - 105.000; Vollzeit

Benefits dieser Stelle

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

Referral Bonus Program – up to $750

Zusammenfassung

Navitus Health Solutions is expanding our Telehealth RN Case Manager position to deliver MTM services for commercial and Medicare members. You will develop programs, support care coordination, and educate stakeholders to improve health outcomes through tele-pharmacy and wellness coaching.

The role emphasizes staying current with CMS regulations and STAR ratings metrics, while collaborating with a multidisciplinary team in a remote setting.

Qualifikationen

• RN with unrestricted licensure required.
• Two years clinical experience including direct consultation preferred.
• Experience as a member of a multi-disciplinary team preferred.
• Professional PBM industry work experience preferred.
• Knowledge of HIPAA and data privacy practices preferred.
• Knowledge of healthcare industry practices and regulations preferred.

Aufgaben

• Conduct MTM and expanded clinical programs per CMS guidelines.
• Develop clinical algorithms, pathways, and call scripts for MTM delivery.
• Review/update algorithms and scripts annually with new guidelines.
• Develop documentation standards for clinical outreaches.
• Assist leadership to develop programs supporting STAR ratings outreach.
• Educate clients, providers, and staff about MTM programs and outcomes.
• Provide Medicare Part D clinical, operational, and educational support.
• Stay current with guidelines and medications to keep MTM programs updated.
• Perform other duties as assigned.

Kenntnisse

Registered Nurse

MTM knowledge

Multidisciplinary teamwork

PBM industry familiarity

Ausbildung

RN license

Tools

PBM software

Jobbeschreibung

Navitus Health Solutions is expanding our Telehealth RN Case Manager position to deliver MTM services for commercial and Medicare members. You will develop programs, support care coordination, and educate stakeholders to improve health outcomes through tele-pharmacy and wellness coaching.

The role emphasizes staying current with CMS regulations and STAR ratings metrics, while collaborating with a multidisciplinary team in a remote setting.