Senior Infusion Referral Nurse

At Prime Therapeutics, we take pride in being a distinct Pharmacy Benefit Manager (PBM) with a mission that transcends profits. If you're seeking a career driven by purpose, join us in building the future of pharmacy. Job Summary As a Senior Infusion Referral Nurse, you will play a crucial role in providing referral services that support independent physician offices in managing drug infusions. Your primary focus will be on facilitating lower-cost treatment options, whether in-office or through home infusion, compared to hospital outpatient facilities. You'll engage with members, discussing financial and clinical aspects of their care to optimize their treatment outcomes. Key Responsibilities Offer site of service solutions to patients seeking care at alternatives to non-preferred treatment sites. Discuss financial considerations of specialty drugs with members and healthcare providers, coordinating infusions at more cost-effective treatment sites. Provide essential resources to assist members in managing their complex illnesses, leveraging critical thinking skills. Support copay assistance programs and organize services that minimize out-of-pocket expenses for drug administration. Maintain an active caseload while ensuring high levels of member satisfaction. Document and manage case information accurately in web-based applications and spreadsheets. Contribute to clinical services, including the appeals program. Engage in regular meetings with management to review member interactions and program effectiveness. Familiarize yourself with community resources and any relevant benefit information. Ensure compliance with all relevant patient record policies and documentation standards. Perform additional duties as assigned. Clinical oversight will be provided by the Manager of Patient Programs. Minimum Qualifications Bachelor's degree in Nursing. Current RN license (state and/or compact state licensure). 5+ years of clinical experience. This position requires eligibility to work in the U.S. without the need for work visa or residency sponsorship. Additional Qualifications Registered Nurse (RN) with at least 5 years of post-degree clinical experience. Experience in managed care, specialty drugs, care management, and utilization review. Ability to apply clinical knowledge in line with evidence-based guidelines. Adept at functioning independently as well as within a team. Strong organizational, time management, and communication skills. Comprehensive clinical understanding of specialty drug management. Understanding of infusion processes across various sites of service. Preferred Qualifications All employees must adhere to security responsibilities and comply with legal, regulatory, and internal policies pertinent to their roles. Prime Therapeutics is committed to fostering a diverse workforce and encourages all qualified candidates, regardless of background, to apply. Salary for this position ranges from $74,000.00 to $118,000.00, based on experience and skills. To learn more about our benefits and additional compensation, please visit our Benefits Page. At Prime Therapeutics, we are eager to welcome individuals from diverse backgrounds and experiences. If you seek a meaningful career focused on simplifying healthcare, we invite you to join us in shaping the future of pharmacy.

Created: 2026-03-07