Job Description
Job Description
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.
Required Skills / Knowledge
- Ability to critically think and apply logic and reasoning to dynamically changing PGx environment.
- Requires superior verbal and written communication skills and service excellence approach with internal and external stakeholders.
- Above average 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, PowerBI, Power Point.
- Ability to embrace usage of various Electronic Health Records (EHRs) and other high tech software programs.
Minimum Education
- Bachelor's degree in nursing (BSN) from an accredited US University.
- Master's Degree (Preferred)
Minimum Work Experience
- 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.
Required Licenses and Certifications
- Active RN license from the state licensing board.
- Case Management certification (preferred)
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