RN, Utilization Case Manager - Archimedes

Navitus Health Solutions, LLC•Bridgeton, MO

1d•Hybrid

About The Position

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

Requirements

Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred. Master of Science in Nursing (MSN) a plus.
Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
Utilization and Case management experience required.
Experience in an infusion setting, physician office or pharmacy required.
Expert at Microsoft Office Suite.

Nice To Haves

Experience with managing specialty medications for patients with chronic illness is highly preferred.

Responsibilities

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.