Registered Nurse Specialty Pharmacy Case Manager
About The Position
The RN Case Management Pharmacy Case Manager II coordinates the care and services of selected Medicaid health plan member populations across the continuum of care, promotes effective utilization and monitoring of health care resources, and assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resource outcomes. RN Pharmacy Case Manager II must be able to effectively assess and coordinate the member’s needs; maximize their available benefits; assist in creating a cost-effective plan of care; and identify high-risk and high-utilization cases. Assigned cases may include components of medical, behavioral health, disease management, complex case management, and/or concurrent (Utilization Review) review. Learn more about the Sentara Case Management Pharmacy at Norfolk General here: https://sentaracasemanagement.com
Requirements
- Bachelor's Level Degree in Nursing/BSN (Required)
- 2 years of related Experience (Required)
- Medicaid Case Management
- Discharge Planning
- Psych setting
- Disease management
- Public Health
- Home Health
- Health Plan
- Specialty Pharmacy
- Health Risk Assessment (HRA)
Nice To Haves
- Certified Case Manager (CCM) (Preferred)
- Accredited Case Manager RN (ACM-RN) (Preferred)
Responsibilities
- Coordinates the care and services of selected Medicaid health plan member populations across the continuum of care
- Promotes effective utilization and monitoring of health care resources
- Assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resource outcomes
- Effectively assess and coordinate the member’s needs
- Maximize their available benefits
- Assist in creating a cost-effective plan of care
- Identify high-risk and high-utilization cases
Benefits
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
