Telehealth RN Case Manager

This is a fully remote position, open to applicants in Idaho.

📋 Description

• Create suitable clinical algorithms, pathways, and call scripts to aid pharmacy staff in providing services.

• Regularly review and revise all algorithms and call scripts at least once a year and in line with updated clinical guidelines.

• Establish documentation standards for all clinical outreach activities.

• Work collaboratively with department personnel to develop and uphold a high-quality and consistent product.

• Facilitate communication and education for clients, providers, and internal staff regarding programs and their outcomes.

• Conduct clinical outreach to members, prescribers, and pharmacy providers to improve care coordination.

• Stay informed about new guidelines, literature, recommendations, and medications, integrating this information into clinical programs and outreach initiatives to ensure services are current.

• Maintain open communication channels with other functional areas and departments.

• Gain a comprehensive understanding of clients’ member experiences and how engagement initiatives enhance health and wellness.

• Comply with all regulations, including HIPAA standards.

• Participate in, adhere to, and promote compliance, people and culture, and learning programs.

• Carry out additional duties as assigned.

⛳️ Requirements

• An Associate’s degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) is required; BSN is preferred.

• A current, active Registered Nurse (RN) license in good standing with the appropriate State Board of Nursing is required.

• A minimum of 2 years of clinical experience, including direct consultation experience.

• Experience in a clinical call center is preferred.

• Experience as part of a multi-disciplinary team is preferred.

• Professional experience in the PBM industry is preferred.

• Familiarity with relevant data privacy practices and laws is preferred.

• Understanding of healthcare industry practices and HIPAA regulations is required.

🏝️ Benefits

• Comprehensive benefits package for Health, Dental, and Vision insurance.

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

• 401K company match of up to 5% with no vesting requirement.

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and Professional Membership support.