Remote Telehealth RN Case Manager - MTM & Wellness

Navitus; Jefferson City (MO); Remote; USD 90,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

20 days paid time off

4 weeks parental leave

9 paid holidays

401K company match

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Professional Membership assistance

Referral Bonus Program - up to $750

Job summary

Navitus Health Solutions is expanding its Clinical Engagement Center and seeks a Telehealth RN Case Manager to deliver MTM services to commercial and Medicare members through tele-pharmacy and wellness coaching. You will support program development and execution of additional outreach to exceed client expectations.

We’re looking for a Registered Nurse with an unrestricted license and at least two years of clinical experience, plus experience in a multidisciplinary team.

Qualifications

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

Responsibilities

• Conduct MTM and expanded clinical programs per CMS guidelines.
• Develop clinical algorithms, pathways, and call scripts for MTM delivery.
• Review/update algorithms and scripts yearly with updated guidelines.
• Develop documentation standards for clinical outreach programs.
• Support leadership to develop programs to improve STAR ratings outreach.
• Coordinate MTM outreach with members, prescribers, and providers to enhance care.

Skills

Registered Nurse

Clinical experience

PBM knowledge

HIPAA knowledge

Education

RN license

Job description

Navitus Health Solutions is expanding its Clinical Engagement Center and seeks a Telehealth RN Case Manager to deliver MTM services to commercial and Medicare members through tele-pharmacy and wellness coaching. You will support program development and execution of additional outreach to exceed client expectations.

We’re looking for a Registered Nurse with an unrestricted license and at least two years of clinical experience, plus experience in a multidisciplinary team.