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RN, Utilization Case Manager
Navitus Health Solutions. Coordinate care between physicians, patients, and pharmacies .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in coordinating care among physicians, patients, and pharmacies while managing specialty medications for patients with complex disease states. Proficient in utilization management and case management, ensuring compliance and high-quality customer service.
Highest-signal resume keywords
Registered Nurse (RN) LicenseUtilization Management ExperienceCase Management ExperienceSpecialty Medication ManagementMicrosoft Office Suite Expertise
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Utilization ManagementCase ManagementSpecialty Medication ManagementInfusion Setting ExperiencePatient Care Coordination
Soft Skills
Customer ServiceCommunicationCollaboration
Certifications & Qualifications
Associate’s Degree in Nursing (ADN)Bachelor of Science in Nursing (BSN)
Industry Keywords
Chronic IllnessComplianceCare ManagementPharmacy CoordinationQuality Targets
About the role
Key responsibilities & impact- Coordinate care between physicians, patients, and pharmacies
- Facilitate access to specialty medications for patients with complex disease states
- Review chart notes and perform utilization management on patient/drug-specific cases
- Coordinate 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 procedures and meet production, productivity, quality, customer service, speed, and efficiency targets
- Complete care management clinical escalations and escalate to account management as appropriate
- Provide required customer service to internal and external customers and represent Archimedes
- Participate in and support compliance, people and culture, and learning programs
- Perform other duties as assigned
Requirements
What you’ll need- Associate’s degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred
- 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
- Experience with managing specialty medications for patients with chronic illness is highly preferred
- Expert at Microsoft Office Suite
Benefits
Comp & perks- 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
- Professional Membership assistance
- Hybrid work arrangement with 3 days in office