Senior RN Care Manager – 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 Title

Senior RN Care Manager – Remote

Job Description

The Sr RN Care Manager plays a critical role in delivering comprehensive, person-centered care by conducting clinical assessments and reassessments, developing and monitoring individualized care plans, and providing ongoing patient education and therapy-specific counseling. This role ensures seamless coordination among patients, caregivers, providers, and specialty pharmacy partners to support optimal treatment outcomes throughout the patient’s care journey.

Responsibilities

• Manage patient caseloads, conduct initial and follow-up assessments, and apply risk stratification to guide outreach and care team interventions
• Serve as the primary point of contact for patients enrolled in specialty care and support quality improvement initiatives such as reporting on adherence, compliance, patient safety and satisfaction
• Develop, implement, and monitor specialty patient care plans, setting measurable goals and promoting patient self-management
• Oversee Risk Evaluation and Mitigation Strategy (REMS) drug safety program requirements for designated medications, ensuring patient compliance and escalating non-adherence as needed
• Ensure continuity of care for newly enrolled patients by identifying needs, aligning care plans, and prioritizing treatment goals
• Assess patient needs and coordinate services while ensuring clear communication among patients, caregivers, providers, and community resources
• Document assessment outcomes, care planning, and clinical escalations accurately and timely, ensuring compliance with regulatory standards
• Must have flexible working hours
• Other duties as assigned

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Minimum Qualifications

• Bachelors degree in Nursing or equivalent combination of education and/or relevant work experience

• Registered Nurse License or Compact State Licensure
• 5 years clinical experience as a Registered Nurse (RN)
• Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

• Skilled in adapting communication strategies to accommodate cognitive or language barriers, ensuring effective engagement with diverse populations
• Exceptional organizational and time management abilities, with a proven capacity to prioritize and manage caseloads efficiently in dynamic environments
• Able to work independently while thriving in collaborative team settings, contributing to shared goals and cross-functional initiatives
• Proficient in applying evidence-based clinical guidelines to support effective care planning and decision-making
• Strong knowledge of care management principles and person-centered care planning, with a focus on holistic, individualized approaches
• Familiarity with complex disease processes and specialty medications, particularly in managing chronic or high-acuity conditions

Preferred Qualifications

• Certified Case Manager (CCM)
• Demonstrated experience in care management, case management, or disease management, including coordination of community-based support services and utilization of durable medical equipment

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $66,000.00 – $106,000.00 based on experience and skills. 

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the “Benefits at a glance” button for more detail (https://www.primetherapeutics.com/benefits).

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.  

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.