Remote Telehealth RN Case Manager - MTM & Wellness

Navitus; Nashville (TN); Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health, Dental, and 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

Professional Membership assistance

Referral Bonus Program – up to $750

Job summary

Navitus Health Solutions seeks a Telehealth RN Case Manager to join our Clinical Engagement Center. You will deliver MTM services for commercial and Medicare members and support clinical outreach programs to improve member health and wellness.

You will develop clinical pathways, support MTM program execution, and collaborate with pharmacists, providers, and staff to enhance care coordination and STAR ratings outcomes in a telehealth setting.

Qualifications

• Active RN license in good standing.
• Minimum 2 years clinical experience preferred.
• Experience in multidisciplinary teams is preferred.
• Knowledge of HIPAA and privacy regulations preferred.
• Medicare MTM knowledge is preferred.

Responsibilities

• Deliver MTM services to commercial and Medicare members.
• Develop clinical algorithms, pathways, and call scripts for MTM delivery.
• Review and update MTM materials yearly with new guidelines.
• Create documentation standards for clinical outreaches.
• Support STAR ratings outreach and related programs.
• Coordinate with clients, providers, and staff on MTM outcomes.
• Provide Medicare Part D clinical and educational support.
• Stay current with CMS guidelines and MTM updates.

Skills

Registered Nurse

Clinical experience

Team collaboration

HIPAA compliance

Education

RN licensure

Job description

Navitus Health Solutions seeks a Telehealth RN Case Manager to join our Clinical Engagement Center. You will deliver MTM services for commercial and Medicare members and support clinical outreach programs to improve member health and wellness.

You will develop clinical pathways, support MTM program execution, and collaborate with pharmacists, providers, and staff to enhance care coordination and STAR ratings outcomes in a telehealth setting.