Medical Review Nurse

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Jacksonville, FL

Job status
Full time
$65,000.00 – $85,000.00 Annually
Job description
Enhanced-MTM Nurse for The Medicare Part D Enhanced Medication Therapy Management Model innovation program. 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.

Education requirements
• Bachelor’s degree in Nursing
• Required Licenses and Certifications
• Registered Nurse - State 5+ years direct patient care experience
• Strong background in primary care and chronic disease management. Combination of inpatient and outpatient experience, preferred.
• Licensure and/or Compact State Licensure
• Experience with Quality Reporting
• Experience working in an anticoagulation clinic
• Experience with identifying pharmaceutical and community-based healthcare resources

Experience requirements


• 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.

Work hours
About us:
Cloudteam has been disrupting the staffing industry since 2011 with our tech tool supported recruitment and staffing teams that have enabled us to offer top level placements with higher compensation and at lower cost to our clients.

We are an Equal Opportunity Employer.