-
Job ID 2107087
Job Description
At Prime Therapeutics, we are dedicated to making a meaningful difference in the lives of individuals by ensuring they have access to the necessary medications to enhance their well-being. Our commitment to this mission is the driving force behind every decision we make.
We are currently seeking an Infusion Referral Nurse to join our remote team. In this vital role, you will play a key part in providing referral services that assist independent physician offices in managing their members’ drug infusion needs, whether at the office or by identifying more cost-effective treatment alternatives like home infusion. Your expertise will guide members and their healthcare providers in considering the financial and clinical implications of higher-cost treatment sites, while actively seeking financial programs designed to reduce out-of-pocket costs for drug infusion services.
Your essential responsibilities will include:
- Offering optimal site of service solutions for patients looking to move away from non-preferred treatment locations, such as hospital facilities.
- Engaging in discussions regarding the financial aspects of specialty drugs with both members and healthcare providers, aiming to facilitate cost-effective treatment alternatives.
- Equipping members with resources and critical information to enhance their treatment outcomes and managing their complex healthcare situations.
- Advocating for copay assistance programs and conducting research to lessen members’ financial responsibilities in either office or home settings for drug services.
- Maintaining a manageable case load that aligns with organizational goals to transition treatment to lower-cost settings while ensuring member satisfaction.
- Accurately documenting cases and entering data using our web-based systems.
- Supporting clinical initiatives, including the appeals program, and participating in meetings with management to review member interactions and program effectiveness.
- Keeping abreast of community resources and relevant benefits information that can enhance the services provided.
- Adhering to all policies concerning patient records and documentation.
To qualify for this opportunity, you must have:
- A current, active Registered Nurse (RN) license.
- A minimum of 5 years of clinical experience post-degree, with experience in managed care, specialty drugs, care management, and utilization review preferred.
- The necessary credentials to meet Magellan’s credentialing criteria.
- Strong organizational, communication, and time management skills, with a proven ability to work independently as well as collaboratively within a team.
- Comprehensive clinical knowledge of medical specialty drugs and their infusion management across various service sites.
At Prime Therapeutics, we offer a competitive salary range of $60,800.00 to $97,280.00 based on your experience and skills, with the possibility of variation depending on your location. To learn more about our comprehensive benefits and incentives, please visit our Benefits Page and click on the "Benefits at a glance" button.
As an Equal Opportunity Employer and a tobacco-free workplace, Prime Therapeutics warmly welcomes applications from individuals of diverse backgrounds. We stand committed to hiring applicants regardless of race, color, religion, sex, sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected status.
If you are ready to take your career to the next level in a fast-paced, collaborative environment dedicated to delivering exceptional care, we invite you to apply and join us in making a difference in the lives of those we serve.