Utilization Management Case Manager - Archimedes

Navitus Health Solutions • Brentwood, TN

2d

About The Position

Archimedes is a rapidly growing leader in the specialty drug benefit management space. We are looking for a Case and Utilization Manager to coordinate care between physicians, patients and pharmacies. This is a great opportunity for a dependable and dedicated candidate with a passion for helping patients taking specialty medications to treat complex disease states.

Requirements

• Case management experience
• Utilization management experience
• Experience with managing specialty medications for patients with chronic illness strongly preferred.
• Strong communication skills to ensure a high-quality patient experience.
• Experience in an infusion setting, physician office or pharmacy
• Self-motivated and able to thrive in a results-driven environment
• Ability to prioritize among competing tasks
• Ability to work independently with limited supervision
• Critical thinking and problem-solving skills
• Excellent time and project management skills.
• Keen attention to detail and adherence to deadlines
• A minimum of a high school degree or equivalent is required
• National Certification from an accredited pharmacy technician certification program approved by specific state regulations (e.g. PTCB, ExCPT, CPhT etc.). or Licensed Practical Nurse (LPN) degree or certificate preferred
• Expert at Microsoft Office Suite

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 .
• Follows established procedures, processes, and standards for production, productivity, quality, and customer-service.
• Meets 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 serves as a representative of Archimedes to all external customers.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees