RN, Registered Nurse Transplant Case Manager

RN, Registered Nurse Transplant Case Manager

Founded in 1999 and headquartered in Central Ohio, we’re a privately owned , independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.

The Transplant Nurse (PCG) facilitates care coordination for a member with the potential for a transplant, including hematologic malignancies and end stage disease processes. The position requires a multidisciplinary, collaborative approach to manage the complexity, financial impact, frequent resource utilization and variable acuity across the transplant continuum. Management begins at referral and follows through pre-transplant care, evaluation, and the transplant phase to post-transplant case closure.

Location:

This position is located at our Dublin, OH campus with hybrid flexibility.

• Identify and assess members with the potential for solid organ or bone marrow transplant, end stage renal disease, and hematologic malignancies.
• Apply the nursing process when actively case managing transplant members.
• Utilize well-developed critical thinking and interpersonal skills to problem‑solve and make knowledgeable recommendations for needed actions.
• Document all activities specific to members, caregivers, providers, facilities and clients in appropriate database.
• Maintain a collaborative relationship with members’ health care teams by communicating information, responding to requests, building rapport, and participating in team problem‑solving methods.
• Serve as member and provider advocate by educating and guiding through the transplant process.
• Provide benefit and health information to each member so they are able to make informed health decisions.
• Maintain a working knowledge of all policies and procedures related to Clinical Operations.
• Work closely with and provide updates to internal client executives and employer contacts for transplant patients.
• Maintain a working knowledge of employer health benefit plans and know where to access benefit information.
• Be a clinical resource for all Quantum Health work teams.
• Maintain working knowledge of Transplant Vendor contracts, single caserate agreements, access agreements, and negotiated agreements as required by client plan design.
• Assist members and clients with wellness activities, enhanced benefits, behavioral incentives.
• Maintain contact with the QH clinical staff for transfer of cases when appropriate.
• All other duties as assigned.

• Licensure:
  Current and active license as a Registered Nurse in the state of Ohio; BSN preferred.
• Experience:
  
  Minimum of two years clinical experience with direct patient care required.
• Certification in Case Management preferred within 2 years of hire.
• Excellent critical thinking skills.
• Possess excellent verbal and written communication skills.
• Demonstrate ability to work autonomously.
• Solid organ or bone marrow transplant experience desired.
• Effective communication skills, both verbal and written.
• A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us.

• Compensation: Competitive base and incentive compensation.
• Coverage: Health, vision and dental featuring our best‑in‑class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
• Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
• Balance: Paid Time Off (PTO), 7 paid holidays, parental…