RN, Utilization Case Manager - Archimedes
About The Position
The RN, Utilization Case Manager coordinates care between physicians, patients, and pharmacies, facilitating access to specialty medications for patients with complex disease states. This position is hybrid in Missouri, with three days in the office during core business hours. The role reviews chart notes and performs utilization management on patient- and drug-specific cases. It coordinates specialty drug treatment and timely delivery to the appropriate site of care, manages case assignments and progress, documents case notes, and determines case closure. The position follows established production, productivity, quality, and customer-service procedures and standards, meets performance targets, handles clinical escalations, and supports compliance, people and culture, and learning programs.
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 patient- and drug-specific cases.
- 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 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.
Benefits
- Health, dental, and vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401(k) company match of up to 5%, with no vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan
- Professional Membership assistance
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
