Job Description

From Intake to Outcomes, CAREMETX is dedicated to supporting the patient journey by providing hub services, innovative technology, and decision-making data to pharmaceutical, biotechnology, and medical device innovators.

JOB TITLE: NURSE EDUCATOR (PREFERRED APPLICANTS MUST RESIDE IN SOUTHERN CA)

POSITION SUMMARY:

Under general direction of the VP, HUB Operations the nurse is responsible for participating in the training, implementation, case management and coordination of nursing call center services secured by CareMetx clients for patients with rare or chronic diseases. Nurse will work in a fully remote environment and will pursue RN licensing in all 50 states. This position will take day to day direction directly from our manufacturer client and utilize all of their systems and phone.

PRIMARY DUTIES AND RESPONSIBILITIES:

1. Executes nursing services in alignment with requirements documented in the Statement of Work (SOW) and Work Instruction associated with the Hub Program being supported
2. Educates and implements agreed clinical services for the patient, physician and family on prescribed specialty drug therapies
3. Provides medical records, as backup for payer prior authorizations, billing and claim support, assuring clinical documentation is in accordance with payer guideline reimbursement
4. Exhibits independence in program specific software programs and all related activities
5. Interacts with Reimbursement team members as directed by each client
6. Provides HIPAA compliant feedback and analysis to the manufacturer as contractually required
7. Always conveys a strong professional image and positive attitude
8. Adheres to and is compliant with mandatory HIPAA requirements
9. Reviews and adheres to all company policies and procedures
10. Effectively communicates with patient, family, provider and team members
11. Responsible for maintaining required licensure/certification
12. Adheres to regulations affecting nursing practice in a call center setting
13. Ability to manage time efficiently within client directed requirements
14. Maintains current, clearly written, and accurate records
15. Ability to work remotely as needed
16. Performs related duties as assigned

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• Requires a minimum Associate Degree in nursing, current licensing/certification
• 2-5 years’ experience in managed care or case management and familiarity with specialty pharmaceutical therapies for rare or chronic diseases.
• RN Licenses in multiple non-compact states beneficial.

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

• Ability for business hours availability
• Excellent interpersonal skills
• Proficient in Microsoft Office Word and Excel
• Knowledge of the case management process
• Ability to communicate effectively both orally and in writing with excellent grammatical skills
• Ability to prioritize workload and consistently meet deadlines
• Knowledge of health benefits and payer processes
• Compassionate and patient-focused
• Ability to carry company issued technology outside of office setting
• Reliable internet service provider (as needed)

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

· While performing the duties of this job, the employee is regularly required to sit.

· The employee must occasionally lift and/or move up to 10 pounds.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

SCHEDULE

• Must be flexible on schedule and hours
• Extensive travel is required (60% travel)

CAREMETX considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.

At CAREMETX we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.

CAREMETX is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.

Company Description

Every day, CareMetx makes a difference in the lives of people facing complex health challenges. CareMetx is a specialty hub services and technology company providing patient-centric services supported by state-of-the-art proprietary technology. Bio-pharmaceutical and device manufacturers who have developed life-changing niche products, come to us to provide expert reimbursement support and clinical services for patients who have been prescribed these innovative products. Aside from having an experienced, compassionate work force, dedicated to the highest quality patient care, CareMetx delivers mobile solutions, dashboards, portals and other technology solutions to help track and manage the patient's journey "from intake to outcomes."​ CareMetx'​ portfolio includes "human services"​ such as reimbursement case management, clinical care coordination, patient assistance program management; and cutting edge technology services such as data aggregation, analysis and reporting solutions that may be "bolted on"​ to existing HUB technology for greater data access. Our mobile data collection and reporting tools for use by manufacturers, providers and patients support and sustain patient access to complex therapies. CareMetx is a privately-held, high-achieving, patient-focused company powered by 21st century technology solutions.