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.

Under supervision, the nurse is responsible for performing referral services to support independent physician offices with maintaining member drug infusions in office or helping offices locate a lower cost alternative treatment site (e.g., home infusion) for drug infusion services versus the hospital outpatient facility. The role discusses financial and clinical considerations with members, researches available financial programs to decrease out‑of‑pocket expenses, and coordinates lower‑cost sites of service for drug administration when providers refer due to convenience factors.

• Provides site of service solutions to patients seeking care at non‑preferred treatment sites.
• Discusses the financial aspects of specialty drugs with members and ordering physicians and coordinates drug infusion at an alternate lower‑cost treatment site.
• Provides members with resources to optimize treatment outcomes, using critical thinking skills and specific resources related to complex illnesses.
• Supports member copay‑assistance programs, researches and coordinates to reduce member out‑of‑pocket responsibility in an office or home setting.
• Actively maintains a required caseload and activities to reach overall goals of switching site of service treatment to a lower‑cost setting while maintaining member satisfaction.
• Documents and enters data of cases in web‑based applications and spreadsheets.
• Supports clinical services such as the appeals program.
• Participates in meetings and consults with management regularly to discuss member interaction and program outcomes.
• Maintains appropriate par levels of literature.
• Familiarizes self with community resources, benefit information and other valued program information.
• Maintains an active caseload and accurate case records, adhering to all company policies and laws governing patient records.
• Performs related duties as requested.
• Clinical and quality oversight for this program is provided by the Manager, Patient Programs.

• Bachelor’s degree in Nursing
• Registered Nurse (RN) with State and/or Compact State licensure in Care Management
• 5+ years of clinical experience
• Must be eligible to work in the United States without the need for work visa or residency sponsorship

• Registered Nurse (RN)
• 5 years of post‑degree clinical experience
• Experience in managed care, specialty drugs, care management, and utilization review
• Meets credentialing criteria; current and active nursing license required
• Ability to apply knowledge in relation to clinical findings from evidence‑based guidelines
• Ability to function independently and as a team member
• Good organizational, time‑management, and communication skills
• Ability to achieve organizational goals through effective team development
• Comprehensive clinical knowledge of medical specialty drugs and their management
• Understanding of the clinical aspects of infusion of those drugs within various sites of service

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

Potential pay for this position ranges from $74,000.00 – $ 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.

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.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at or email