Navitus Health Solutions

RN, Utilization Case Manager - Archimedes

Navitus Health Solutions  •  Missouri (Hybrid)  •  14 days ago
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Job Description

Company

Archimedes

About Us

Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit – alignment, value and transparency – Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. .____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $0.00 - USD $0.00 /Yr.

STAR Bonus % (At Risk Maximum)

0.00 - Ineligible

Work Schedule Description (e.g. M-F 8am to 5pm)

Our Core Business Hours-Hybrid Work Schedule 3 Days In Office

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

Responsibilities

How do I make an impact on my team?

  • 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.

Qualifications

What our team expects from you?

  • Education: Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred. Master of Science in Nursing (MSN) a plus.
  • Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
  • Experience:
    • Utilization and Case management experience required.
    • Experience in an infusion setting, physician office or pharmacy required.
    • Experience with managing specialty medications for patients with chronic illness is highly preferred.
    • Expert at Microsoft Office Suite.

What can you expect from Archimedes?

  • Top of the industry benefits for Health, Dental, and Vision insurance
  • 20 days paid time off
  • 4 weeks paid parental leave
  • 9 paid holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and Professional Membership assistance

Location : Address

502 Earth City Expy STE 300

Location : City

Earth City

Location : State/Province

MO

Location : Postal Code

63045

Location : Country

US

Navitus Health Solutions

About Navitus Health Solutions

Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time.

Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.

Industry
Healthcare & Social Services
Company Size
1,001-5,000 employees
Headquarters
Madison, WI
Year Founded
2003
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