RN - Hybrid Pre-Certification Pharmacy Review

Quantum Health; Dublin (OH); Hybrid; USD 60,000 - 75,000; Full time

Job summary

A healthcare navigation organization located in Dublin, OH, is seeking an Entry Level Registered Nurse for their Pre-Certification Pharmacy Review role. This position involves reviewing and processing coverage determinations for specialty medications and collaborating with a multi-disciplinary clinical team. Ideal candidates will hold an RN license, have strong critical thinking and communication skills, and a minimum of 2 years nursing experience. The position offers a full-time employment opportunity with hybrid flexibility.

Qualifications

• Current and Active license as a Registered Nurse (RN) in Ohio.
• Minimum of 2 years of direct care nursing experience.
• Experience with Specialty Pharmacy/Pharmaceuticals preferred.

Responsibilities

• Review and process all requests for specialty medications.
• Communicate with members and internal work groups regarding requests.
• Identify care coordination opportunities and work with clinical teams.

Skills

Critical thinking skills

Strong interpersonal skills

Communication skills

Organizational skills

Education

Bachelor’s degree in nursing or closely related field

Tools

Microsoft Office (Outlook, Word, Excel, PowerPoint)

Job description

A healthcare navigation organization located in Dublin, OH, is seeking an Entry Level Registered Nurse for their Pre-Certification Pharmacy Review role. This position involves reviewing and processing coverage determinations for specialty medications and collaborating with a multi-disciplinary clinical team. Ideal candidates will hold an RN license, have strong critical thinking and communication skills, and a minimum of 2 years nursing experience. The position offers a full-time employment opportunity with hybrid flexibility.