Excellus Health Plan Inc.
Medical Drug Nurse Coordinator I/II/III (RN needed)- 021049 (Healthcare)
PLEASE NOTE: With limited exceptions, our company is requiring all employees to be vaccinated against COVID-19 by Jan. 1, 2022. We also currently mandate vaccinations for employees who enter our buildings. Please keep this in mind when applying for positions at our organization.
The Medical Drug Nurse Coordinator is responsible for coordinating, integrating, and monitoring the use of pharmacy, medical drug and health care services for members, ensuring compliance with internal and external standards set by regulatory and accrediting entities. Performs assessment for site of care, refers appropriate cases to the Pharmacist and/or Medical Director for review, identifies billing trends and refers possible medical fraud to the Special Investigations Unit. Also refers to other internal resources when appropriate, such as case management for members with complex medical needs. The Medical Drug Nurse Coordinator may also perform a variety of technical and administrative tasks essential to the efficient operation of the Medical Specialty Drug Unit and the Pharmacy Department.
Essential Responsibilities/Accountabilities:
Level I:
Level II (in addition to Level I essential responsibilities/accountabilities):
Level III - (in addition to Level II essential responsibilities/accountabilities):
Minimum Qualifications:
NOTE:
We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.
All Levels:
Level I:
Level II (in addition to Level I minimum qualifications):
Level III (in addition to Level II minimum qualifications):
Physical Requirements:
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The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.
Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.
OUR COMPANY CULTURE:
Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
RN