The Care Navigator I is responsible for performing Comprehensive Medication Reviews (CMR) for members enrolled in the Medication Therapy Management (MTM) program. The nurse provides telephonic outreach focused on helping members navigate complex medication regimens, patient safety and adherence concerns during the CMR.

The associate is responsible for the functions below, in addition to other duties as assigned:

• Perform telephonic CMRs to assess medication therapies while documenting interventions and communications to optimize member outcomes. Interactions are generally 90% outbound and 10% inbound calls.
• Utilize established screening criteria for identified members to address specific clinical interventions and facilitate member clinical program engagement
• Support quality improvement programs by analyzing medication usage reports to identify problems and recommend solutions.    
• Identify strategies to decrease pharmacy costs for members to improve medication adherence.

QUALIFICATION REQUIREMENTS

To perform this job successfully, the associate must be able to perform each essential duty satisfactorily.

The requirements listed below are representative of the knowledge, skills, and/or abilities required:

• High School Diploma or General Education Degree (GED)
• Two (2) or more years working in a clinical setting as Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)
• Medicare Part D knowledge, telephonic case management and/or call center experience preferred
• Sound clinical judgment
• Technology savvy; experience using Windows-based software including the Microsoft Office suite
• Active LPN or LVN license in good standing; with ability to obtain and maintain multi-state nursing licenses, as dictated by business needs.
• Required to reside in a state that is part of the Nurse Licensure Compact and hold multi-state privileges
• Excellent verbal and written skills in English; fluent in Spanish a plus

SCHEDULE

Candidates must be able to work the schedule of 9:30 am to 6:00 pm Mountain Time Monday – Friday. Saturdays may be necessary based on business needs.           

Full-time, regular role

LOCATION

This position is a home-based remote position. Candidates will need to meet Health Dialog’s remote working requirements.

Required Skills Required Experience