Infusion Referral Nurse Sr – REMOTE

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.Job Posting TitleInfusion Referral Nurse Sr – REMOTEJob DescriptionThe 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.). ResponsibilitiesProvide 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 assignedMinimum QualificationsBachelors 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 required5 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 sponsorshipAdditional QualificationsAbility to apply knowledge in relation to clinical findings from evidence-based guidelinesAbility to function independently and as a team memberGood organizational, time management and communication skillsPossess the ability to achieve organizational goals through development of effective teamsComprehensive clinical knowledge of medical specialty drugs and the management of those dru...