Telehealth RN Case Manager - Archimedes

Archimedes; Concord (NH); Remote; USD 75,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Paid time off 20 days

Parental leave 4 weeks

Paid holidays 9

401K company match

Adoption Assistance

Flexible Spending Account

Educational Assistance

Job summary

Archimedes is seeking an RN Case Manager for Telehealth to improve members' health and wellness through tele-pharmacy services. The role involves developing and executing clinical outreach programs to exceed client expectations and coordinating care with providers.

This remote-friendly position can be located in various offices, with options for St. Louis, MO or Brentwood, TN, and remote associates are welcome. The RN must hold an active RN license and have current clinical experience.

Qualifications

• ADN or BSN required; RN license active and in good standing.
• 2+ years clinical experience including direct consultation.
• Experience in a clinical call center is preferred.
• Experience as a member of a multi-disciplinary team is preferred.
• Knowledge of HIPAA regulations and healthcare privacy practices.

Responsibilities

• Develop clinical algorithms, pathways and call scripts to support staff.
• Review and update all algorithms and call scripts annually or with updated guidelines.
• Develop documentation standards for clinical outreach.
• Collaborate with staff to maintain high quality, consistent products.
• Provide clinical outreach to members, prescribers, and providers to enhance care coordination.

Skills

Clinical experience

Clinical call center

HIPAA knowledge

PBM industry knowledge

Education

ADN/BSN

Job description

Overview

The RN Case Manager, Telehealth (RN) will focus on improving members’ health and wellness via tele-pharmacy. In addition, the RN will assist in the development and execution of additional clinical outreach program(s) to exceed client expectations.

This role could be located out of our St Louis MO or Brentwood TN offices. We will consider remote associates as well.

Responsibilities

How do I make an impact on my team?

• Develop appropriate clinical algorithms, pathways and call scripts to support pharmacy staff in delivering services.
• Review and update all algorithms and call scripts at least yearly and with updated clinical guidelines.
• Develop documentation standards for all clinical outreach.
• Collaborate with department staff to develop and maintain a high quality and consistent product.
• Facilitate communication and education to clients, providers, and internal staff regarding programs and program outcomes.
• Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination.
• Stay current with new guidelines, literature, recommendations, and medications, and integrate that information into clinical programs and outreach efforts to ensure services remain up to date.
• Maintain open lines of communication with other functional areas and departments.
• Develop a full understanding of clients’ member experience and how engagement efforts contribute to improved health and wellness.
• Adhere to compliance and HIPAA regulations.
• Participate in, adhere to, and support compliance, people and culture, and learning programs.
• Perform other duties as assigned.

Qualifications

What our team expect from you?

• Education: Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred.
• Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
• Experience:
  • 2+ years clinical experience including direct consultation experience.
  • Experience in a clinical call center is preferred.
  • Experience as a member of a multi-disciplinary team is preferred.
  • Professional PBM industry work experience is preferred.
  • Knowledge of applicable data privacy practices and laws is preferred.
  • Knowledge of healthcare industry practices and HIPAA regulations.

What can you expect from Archimedes?

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance

Navitus Health Solutions is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other characteristic protected by law.

Equal employment opportunity, including veterans and individuals with disabilities.