Medical Review Nurse
Enhanced-MTM Nurse for The Medicare Part D Enhanced Medication Therapy Management Model innovation program.
Representative Role Responsibilities: The Enhanced- MTM Nurse has a strong healthcare background treating chronic disease states as part of an interdisciplinary team in the Medicare age population. This position will be required to manage a patient panel and help navigate PDP members through the care continuum and collaborate with internal PDP team members, community healthcare clinicians, and vendors.
- Assist members in overcoming barriers to obtaining medication(s) and reducing hospital admissions and/or readmissions
- Communicate with community based clinicians on closing medication gaps
- Inform and educate the Enhanced-MTM team on medication gaps, activities, issues, or concerns about the population
- Identify and report on healthcare disparities within the population
- Assist in chart review and clinical care meetings
- Analyze population based trends
- Responsible for providing weekly status reports on time and with high quality and completeness.
- Accountable for developing insightful summaries and recommending actions.
- Monitors and evaluates immerging trends.
- Investigates and discovers areas of opportunity and vendor quality checks
- Assists in the analysis of processes and programs in achieving stated goals.
- 5+ years direct patient care experience. Experience details: strong background in primary care and chronic disease management. Combination of inpatient and outpatient experience, preferred.
- Bachelor’s degree in Nursing
- Required Licenses and Certifications
- Registered Nurse- State Licensure And/Or Compact State Licensure
- Strong communication skills with an interdisciplinary healthcare team
- Experience with Quality Reporting
- Experience working in an anticoagulation clinic
- Experience with identifying pharmaceutical and community based, healthcare resources
If you have any questions, please call 904-998-9414 and reference Medical Review Nurse position.
Job Status: Full Time