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Healthcare, Pharmacy Benefits Management (PBM)

Telehealth RN Case Manager - Archimedes

RemoteRemoteFull TimeManager / HeadPosted 11 days agoVisa sponsorship available

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Required skills

  • RN
  • Case Manager
  • Telehealth
  • HIPAA
  • clinical algorithms
  • call scripts
  • documentation standards
  • care coordination
  • Registered Nurse License
  • clinical experience

Nice to have

  • BSN
  • data privacy
  • PBM industry
  • clinical call center
  • multi-disciplinary team

Role summary

Archimedes is seeking a Telehealth RN Case Manager to focus on improving member health and wellness through tele-pharmacy and clinical outreach programs. The role involves telehealth coaching, remote engagement with members and prescribers, and supporting department leadership with clinical resources, medication reviews, and policy development. Responsibilities include developing and updating clinical algorithms, pathways, and call scripts, establishing documentation standards, and facilitating communication with clients, providers, and internal staff. The RN will stay current with guidelines and integrate new information into programs, maintain open communication with other departments, and understand the client's member experience. Adherence to compliance and HIPAA regulations is mandatory.

Company

Archimedes

Work Schedule Description (e.g. M-F 8am to 5pm)

Monday – Friday 8 – 4:30pm

Remote Work Notification

ATTENTION: Archimedes is only able to offer remote work to residents of Alabama, Colorado, Florida, Georgia, Indiana, Illinois, Iowa, Kansas, Kentucky, Maryland, Minnesota, Missouri, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia, Wisconsin.

Hiring Manager : Full Name: First Last

Karmen Stephens

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.Additional responsibilities will be the provision of telehealth coaching to members in a variety of new program offerings aimed at improving adherence and driving to the lowest net cost formulary options. Remote engagement with members and prescribers will be frequent. The RN will also support department leadership with development of appropriate clinical resources, recommendations regarding targeted medication review selections, and policies and procedures. Other support provided will include clinical oversight of pharmacy technicians, pharmacy interns, and products including reporting and audit support.

This role could be located out of our St Louis MO or Brentwood TN offices or fully remote.

Is this you? Find out more below!

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 expects from you?

  • Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred.
  • Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
  • 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 

#LI-Remote

Pay Range

USD $0.00 - USD $0.00 /Yr.
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