Associate Case Manager - Temp

Abarca Health•San Juan, PR

3d•Hybrid

About The Position

The Associate Case Manager helps carry out Medication Therapy Management (MTM) and Disease Management (DM) programs through direct telephone or face-to-face contact with beneficiaries. The role discusses beneficiaries’ chronic conditions and medication treatments to assess how treatment affects their health, provides information about condition management and alternative drug therapies and treatments, and collects data such as medical history, medications, and lifestyle choices. The position works with a Health Educator and cross-functional teams to provide relevant information and high-quality service, promote medication safety and compliance, and help ensure the programs add value to participants’ health and lives. It also requires keeping current with advances in drug therapies and chronic condition management and ensuring compliance with Centers for Medicare & Medicaid Services (CMS). Abarca offers a flexible hybrid work model requiring certain on-site workdays for the Puerto Rico location. The role may require on-call availability, including evenings, weekends, and holidays, depending on operational demands.

Requirements

Associate’s or bachelor’s degree of science in nursing.
Current and active nursing license.
At least 3 years of work-related experience.
Knowledge of basic therapy management concepts, including asthma, diabetes, hypertension, CHF, and cholesterol.
Excellent oral and written communication skills.
Availability to work in a specified time zone or schedule to accommodate business needs.
Ability to access and navigate each department at the organization’s facilities.
Ability to perform sedentary work primarily involving sitting or standing.

Nice To Haves

Experience related to the geriatric population.
Understanding of pharmacy benefit manager clinical operations and Medicare Part D.

Responsibilities

Discuss and update medical histories, conditions, treatments, and lifestyles with beneficiaries participating in MTM and DM programs.
Answer beneficiaries’ questions about medication therapies and bioequivalent alternatives, and provide other needed assistance.
Educate beneficiaries about the importance of following medication indications properly.
Help ensure MTM and DM programs make a difference and add value to participants’ lives and health.
Work with the Health Educator to ensure participants receive necessary and relevant information.
Promote medication safety and compliance.
Ensure compliance with Centers for Medicare & Medicaid Services (CMS).
Work with cross-functional teams to plan and execute clinical projects that deliver high-quality service to clients and partners.
Stay informed about advances in drug therapies and chronic condition management.