RN Case Manager; Pharmacogenomics

Overview

The Pharmacogenomics (PGx) Nurse Case Manager is responsible for comprehensively and actively maintaining the care management and coordination needs of payer defined and/or payer enrolled populations of members who meet designated inclusion criteria. This includes activities such as providing pre-authorization for testing, retrieving test results, and monitoring/tracking the continuation of care. Through these activities, the Nurse Case Manager will partner with providers, pharmacies, labs, payers, and community resources to facilitate effective, efficient care delivery options.

• Maintain care management and coordination needs for payer defined and/or payer enrolled populations who meet designated inclusion criteria.
• Provide pre-authorization for genetic or PGx testing and assist with test result retrieval.
• Monitor and track the continuation of care across the care continuum.
• Partner with providers, pharmacies, laboratories, payers, and community resources to facilitate effective and efficient care delivery options.

• Ability to critically think and apply logic and reasoning to dynamically changing PGx environment.
• Superior verbal and written communication skills and a service excellence approach with internal and external stakeholders.
• Interpersonal skills required to work with people of a broad range of socioeconomic and cultural backgrounds.
• Ability to contribute to policy and procedure formulation when working in partnership with a multidisciplinary team of health care providers.
• Ability to develop and execute programs and lead process improvement projects.
• Ability to provide leadership, influence others to meet member needs and achieve shared goals, to effectively prioritize resources to provide quality and valued member care, promote cooperative behaviors, act as a role model, resource and mentor.
• Proficient at keyboarding and Microsoft Office Word, Excel, Access, Power
  
  BI, Power Point.
• Ability to embrace usage of various Electronic Health Records (EHRs) and other high tech software programs.

• Bachelor's degree in nursing (BSN) from an accredited US University.
• Master's Degree (Preferred)

• Two (2) years medical surgical experience in an acute care setting.
• Three (3) years Nursing experience in medical case management, ambulatory nursing or community/homecare experience.

• Active RN license from the state licensing board.
• Case Management certification (preferred)