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Care Management (RN) Specialty -Remote ID-14041

Job Summary:


Responsible for patient focused programs which may include but is not limited to: collaborating with health care team in providing direction for maintaining high quality patient care, outcomes, and goals for patients; provides enhanced services support and assistance with contractually required Biopharma programs. Follows specific care modules or standard operation procedures approved by the Clinical and Professional Services Team including scripting, assessments, screenings, and education.

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Provides enhanced nursing services support, evaluating diagnoses and other clinical criteria to complete requests for prior authorization, specialty care specific to the department and patient needs in an effort to provide exceptional care and support. Administers clinical training and orientation programs and validates and educations subcontracted nursing providers knowledge base.


Job Responsibilities:


+ Completes initial screening for patients which may include:

+ Assists with infusion pump programming and troubleshooting based on Plan of Treatment (POT);

+ Completes system driven assessments such as Depression Screenings for select disease states;

+ Conducts follow-up assessments and outreach to determine medication history and to improve medication adherence;

+ Provides disease state education including medication administration, resources on side effect management, outreached to MDO, etc.

+ Responsible for the daily nursing care activities, including completion of nursing coordination/plan of treatment forms, building supply lists, nursing assessments, initial screenings, and surveys for patients, programming and troubleshooting infusion pumps based on the Plan of Treatment (POT) established by a pharmacist, injection site/infusion site education training/techniques, obtaining nursing orders, assay management and patient clinical nursing management, and follow up calls to patients as appropriate per specialty.

+ Audits and reports daily on team and individual performance metrics and quality statistics and assist with extrapolation of system applications to develop reports of data from regarding productivity trends.

+ Assists in developing, updating, and implementing departmental Standard Operating Procedures related to system applications, programs, processes and merchandise.

+ Provides support within the scope of practice for a nurse and escalating to pharmacist for patient specific medication questions, including side effect management and quality of life screening.

+ May work with specific nursing specialties such as but not limited to: Infusion Care, Fertility Order, Nursing Network, Care Management.

+ May have other responsibilities delegated as specific to nurse specialty and as designated by the specific department, other responsibilities as judgment or necessity dictate.

+ Reviews prior authorization criteria for specified payers related to defined medications. Evaluates all requests for prior authorizations, appeals and accompanying tasks.

+ Provides nursing network subject matter expert support; administers tracking pharma and payer related nursing documentation request; advises on complex cases and assists in quality care resolution.

+ Acts as a liaison between physicians/practitioners, medical consultants and facility clinical staff.

+ Participates in professional organizations and workshops to gain additional job related knowledge, in service programs and continuing education as required.

+ Serves as Point of Contact for disease-specific operations teams.


About Walgreens


Founded in 1901, Walgreens (www.walgreens.com) has a storied heritage of caring for communities for generations and proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico, and leading omni channel platforms. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for retail pharmacy and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.

Walgreens is the flagship U.S. brand of Walgreens Boots Alliance, Inc. (Nasdaq: WBA), an integrated healthcare, pharmacy and retail leader. Its retail locations are a critical point of access and convenience in thousands of communities, with Walgreens pharmacists playing a greater role as part of the healthcare system and patients care teams than ever before. Walgreens Specialty Pharmacy provides critical care and pharmacy services to millions of patients with rare disease states and complex, chronic conditions.
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