Telehealth RN Case Manager

Job Summary

Working remotely in a full-time capacity, the Telehealth RN Case Manager will manage Medication Therapy Management (MTM) services and assist in developing clinical outreach programs to enhance member health and wellness.

Key responsibilities

• Conduct medication therapy management (MTM) and expanded clinical programs in accordance with CMS guidelines
• Develop clinical algorithms, pathways, and call scripts to support pharmacy staff in delivering MTM services
• Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination

Required qualifications

• Registered Nurse with unrestricted licensure
• Two years of clinical experience, including direct consultation experience preferred
• Experience as a member of a multi-disciplinary team is preferred
• Knowledge of healthcare industry practices and HIPAA regulations
• Professional PBM industry work experience is preferred