Home Infusion RN Case Manager (RN)|MCK Home Infusion at Abarca Health

Sioux Falls, South Dakota, United States

Apply Now

Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, PharmacyIndustries

Requirements

Registered Nurse (RN) - active license in the state of practice upon hire
Visual acuity adequate to perform position duties
Ability to communicate effectively with others, hear, understand, and distinguish speech and other sounds
Commitment to Avera’s mission, vision, core values, and social principles
Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE)
Maintain confidentiality
Work effectively in a team environment
Comply with safety principles, laws, regulations, and standards (e.g., CMS, The Joint Commission, DHHS, OSHA)
Preferred
Specialty Certification in area of nursing practice upon hire
1-3 years of experience

Responsibilities

Collaborate with the multidisciplinary care team to establish patient treatment plans and assist with transitions between levels of care
Facilitate efficient utilization of resources and identify patient care needs throughout the continuum of care
Act as liaison with hospitals and other health care services to provide treatment advice and advocate for patients with payor sources
Identify community resources for non-covered benefits (e.g., medications, nutritional supplements, transportation, durable medical equipment)
Provide patient care and assist providers as needed
Complete documentation, obtain insurance prior authorizations, and coordinate scheduling of procedures, testing, and treatments
Perform and assist with medical treatment teaching and follow-up care for patients and families
Assist with updating policies and procedures pertinent to the area of responsibility
Assist with review and development of patient education materials
Attend discharge planning meetings to facilitate and coordinate post-procedure needs of discharged patients

Skills

Case Management

Patient Care

Insurance Prior Authorization

Care Coordination

Patient Education

Discharge Planning

Documentation

Abarca Health

Pharmacy Benefit Management services provider

About Abarca Health

Abarca Health provides Pharmacy Benefit Management (PBM) services, focusing on flexible and user-friendly solutions for health plans, employers, and government programs like Medicare and Medicaid. Its main product, the Darwin platform, allows clients to quickly implement and modify benefit designs while ensuring compliance with regulations. Abarca Health manages over $5.3 billion in drug spend and processes 100 million prescription claims annually, offering additional services like home delivery for prescriptions. The company's goal is to deliver exceptional service and innovative solutions in the PBM market.

Aventura, FloridaHeadquarters

2005Year Founded

VENTURE_UNKNOWNCompany Stage

HealthcareIndustries

501-1,000Employees

Benefits

PTO

Parental leave

Work flexibility

Health insurance

Wellness stipend

401k

Tuition reimbursement

Leadership development programs

Risks

Increased competition from Amazon Pharmacy and Mark Cuban's Cost Plus Drug Company.

Growing focus on specialty drugs may require platform adaptation.

Shift towards price transparency could pressure Abarca's pricing models.

Differentiation

Abarca Health's Darwin platform is highly adaptable and user-friendly.

The company offers innovative programs like Triple S en Casa for home delivery.

Abarca Health ensures compliance with ever-changing healthcare regulations.

Upsides

Abarca transitioned two million members to Darwin in 18 months, showing operational efficiency.

Collaboration with Blue Shield of California boosts Abarca's reputation in the PBM sector.

Recognition as a top IT workplace attracts top talent, driving innovation.

Land your dream remote job 3x faster with AI

Try Jobo Free