RN, Utilization Case Manager - Archimedes

Navitus Health Solutions•Earth City, MO

4d•Hybrid

About The Position

The RN, Utilization Case Manager coordinates care among physicians, patients, and pharmacies to facilitate access to specialty medications for patients with complex disease states. This is a hybrid position in Missouri, with three days in the office during core business hours.

Requirements

Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required.
Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing required.
Utilization and case management experience required.
Experience in an infusion setting, physician office, or pharmacy required.
Expertise with Microsoft Office Suite.

Nice To Haves

Bachelor of Science in Nursing (BSN) preferred.
Master of Science in Nursing (MSN) is a plus.
Experience managing specialty medications for patients with chronic illness is highly preferred.

Responsibilities

Review chart notes and perform utilization management on a patient- and drug-specific case basis.
Coordinate patients’ specialty drug treatment and ensure timely delivery to the appropriate site of care.
Handle case assignments, review case progress, 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 and escalate to account management as appropriate.
Ensure internal and external customers receive the level of customer service required by Archimedes, and represent Archimedes to external customers.
Participate in, adhere to, and support compliance, people and culture, and learning programs.
Perform other duties as assigned.