RN, Utilization Case Manager - Archimedes in Earth City, Missouri at Archimedes

Overview

The RN, Utilization Case Manager will coordinate care between physicians, patients, and pharmacies, facilitating access to specialty medications for patients with complex disease states.

Responsibilities

How do I make an impact on my team?

• Review chart notes and perform utilization management on patient/drug specific case basis.
• Coordinate facilitation of patients’ specialty drug treatment, ensuring timely delivery to the appropriate site of care.
• Handle case assignments, review case progress, properly document case notes, and determine case closure.
• Follow established procedures, processes, and standards for production, productivity, quality, and customer service. Meet performance targets for speed, efficiency, and quality.
• Complete care management clinical escalations. Escalate to account management as appropriate.
• Ensure all external and internal customers receive the level of customer service required by Archimedes and serve as a representative of Archimedes to all external customers.
• 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?

• Education: Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred. Master of Science in Nursing (MSN) a plus.

• Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.

• Experience:
  • Utilization and Case management experience required.
  • Experience in an infusion setting, physician office or pharmacy required.
  • Experience with managing specialty medications for patients with chronic illness is highly preferred.
  • Expert at Microsoft Office Suite.

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.