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Medical Review Nurse
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Information Technology company
ContractContract to Permanent
Information Technology company
Jacksonville, FL ( Map it )
Jacksonville, FL
ContractContract to Permanent

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 emerging trends.
• Investigates and discovers areas of opportunity and vendor quality checks
• Assists in the analysis of processes and programs in achieving stated goals.

Role Requirements:
• 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

Preferred:
• 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

Skills
Skill Proficiency Years Experience Percent Used
Registered Nurse
3 - 6100%
Medicare
1 - 375%
Nursing
Any25%
Education
Bachelor's
Required