Prime Therapeutics

Infusion Referral Nurse Sr – REMOTE

Prime Therapeutics$74K — $118K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Nursing or related field, or equivalent education/work experience
  • 5 years' experience in a clinical infusion setting
  • Current RN license in applicable state(s)
  • Ability to apply clinical findings using evidence-based guidelines
  • Good organizational, time management, and communication skills

Responsibilities

  • Provide solutions for patients at non-preferred treatment locations by coordinating transitions to lower-cost alternatives
  • Educate members and providers on specialty drug financial impacts to facilitate cost-effective treatment agreements
  • Document and enter case data into web applications and spreadsheets
  • Coordinate drug infusions and services at alternate sites to reduce healthcare costs
  • Support members with copay assistance programs and financial resources to minimize out-of-pocket expenses
  • Use clinical knowledge to connect members with resources for optimal treatment outcomes
  • Maintain an active caseload with accurate documentation to comply with policies and laws

Benefits

  • Comprehensive health plans
  • Flexible work arrangements
  • Career development programs
  • Wellness benefits
  • Retirement savings plans
Full Job Description
Infusion Referral Nurse Sr – REMOTE The Infusion Referral Nurse Sr is responsible for performing referral services to support independent physician offices with maintaining member drug infusions in office or to help offices locate a lower cost alternative treatment site (e.g., home infusion) for drug infusion services versus the hospital outpatient facility. This role discusses financial and clinical considerations with members who are considering care at a higher cost treatment site, researches available financial programs to decrease members' out-of-pocket expense for drug services in office and coordinates lower cost site of service for drug administration if provider is referring due to convenience factors (e.g., distance, non-typical infusing provider, etc.). Responsibilities Provide site-of-service solutions for patients receiving care at non-preferred treatment locations, coordinating transitions to lower-cost alternatives (e.g., Hospital inpatient or outpatient facilities, non-pat cancer treatment centers, etc.) Educate members and providers on the financial impact of specialty drugs, facilitating agreement on cost-effective treatment sites Document and enter data following each case in web-based application and spreadsheets Coordinate drug infusions and related services at alternate treatment sites to reduce overall healthcare costs Support members with copay assistance programs and financial resources to minimize out-of-pocket expenses Apply clinical knowledge and critical thinking to connect members with resources that optimize treatment outcomes Maintain an active caseload, ensuring accurate documentation in web-based systems and spreadsheets in compliance with company policies and laws Validate prior authorizations and site-of-service cases, synthesizing clinical data to support product initiatives and workflows Other duties as assigned Minimum Qualifications Bachelors degree in Nursing or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or equivalent GED required 5 years of work experience in a clinical infusion setting Current Registered Nurse (RN) license to practice in the applicable state(s) Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications Ability to apply knowledge in relation to clinical findings from evidence-based guidelines Ability to function independently and as a team member Good organizational, time management and communication skills Possess the ability to achieve organizational goals through development of effective teams Comprehensive clinical knowledge of medical specialty drugs and the management of those drugs Understanding of the clinical aspect of the infusion of those drugs within various sites of service Preferred Qualifications Experience in managed care, specialty drugs, care management and utilization review Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job Potential pay for this position ranges from $74,000.00 - $118,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

About Prime Therapeutics

Prime Therapeutics is a pharmacy benefit management company that serves health plans, employers, and government programs. The company was founded in 1998 and is headquartered in Eagan, Minnesota. Prime Therapeutics manages prescription drug benefits for more than 30 million people across the United States. The company's services include claims processing, formulary management, and clinical programs. Prime Therapeutics is owned by 18 Blue Cross and Blue Shield health plans. In 2017, the company reported revenue of $5.3 billion.
Learn more about Prime Therapeutics
Size
4,000 employees
Industry
Founded
1990

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