Company name
Quantum Health LLC.
Location
Dublin, OH, United States
Employment Type
Full-Time
Industry
Healthcare, Nursing
Posted on
Jun 11, 2023
Profile
Description
Location:
This position is
located
at our Dublin, OH campus with hybrid flexibility.
Multistate Licensure:
Quantum Health nurses must be willing and able to obtain and
maintain
nursing licensure in multiple states, as required by the business. All application and filing fees will be paid by Quantum Health.
We’re
on a mission to make healthcare
simpler and more effective. We fight to ensure our members get the care they need, when they need it, at the most affordable cost –
that’s
what makes us Healthcare Warriors™. If
you’d
like to join us,
we’d
love to talk to you – even if you
don’t
match
every single requirement.
The
Registered Nurse (RN) – Transplant Patient Care Guide
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, the transplant phase to post-transplant case closure
What
you’ll
do
Identify
and assess members with the potential for solid organ or bone marrow transplant, end stage renal disease and hematologic malignancies
Engage telephonically with eligible members and transplant facility case managers to educate on plan structure related to transplant, facility
selection
, and travel and lodging reimbursement.
Perform post discharge calls.
Provide
Utilization Management for Transplant listing requests for
identified
population.
Maintain a working knowledge of all benefit plans and know where to access the needed information.
Negotiate for services needed if no clear benefit exists or if the services can only be
provided
out of network.
Collaborate with the Stop Loss Carrier and TPA vendors for all Transplant specific language, contracting, and claims payment provisions
Maintain working knowledge of how to secure Transplant Vendor contracts,
single case
rate agreements, access agreements, and negotiated agreements as required by client plan design
Be a clinical resource for all Quantum Health work groups.
Work closely with and
provide
updates to internal client executives and employer contacts for transplant patients.
Maintain contact with the QH clinical staff for transfer of cases when appropriate
Participate in new hire, clinical and pod staff training as needed or
appropriate
All other duties as assigned.
What
you’ll
bring
Licensure: Active license in good standing as a Registered Nurse (RN) in Ohio
required
Education: Bachelor of Science in Nursing (BSN) preferred.
Completion of specialized training in Advanced Achievement in Transplant Management (AATMC) or willingness to complete within two years of employment.
Experience:
2 years of clinical experience with direct patient care
required
Proven clinical experience with
organ
and/
or bone marrow transplant
s, preferred
Excellent verbal and written communication skills. Comfortable communicating with members and providers via phone regularly throughout the day.
Ability to communicate effectively with members and providers in implementing clinical services; Translate complex clinical concepts for non-clinical audiences.
Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
Trustworthy and accountable behavior, capable of viewing and
maintaining
confidential personal information daily
What’s
in it for you
Compensation:
Competitive base pay, incentive plans and employee referral bonuses.
Coverage:
Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption
assistance
, EAP, Tela
d
oc 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 leave, volunteer days, paid sabbaticals, and more.
Development:
Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid
trainings
and leadership development.
Culture:
Recognition as
a Best
Place to Work for 15 years, dedication to
diversity, philanthropy and sustainability
, and people-first values that drive every decision.
Environment:
A modern workplace with a casual dress code, open floor plans, full-service dining, free
snacks
and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room,
notary
and dry-cleaning services and more! Check out our home:
https://youtu.be/xRnbvCW_YgA
What you should know
Internal Associates:
Already a Healthcare Warrior? Apply internally through Jobvite.
Process:
Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check
Diversity,
Equity
and Inclusion:
Quantum Health welcomes everyone. We value our diverse team and suppliers,
we’re
committed to empowering our ERGs, and
we’re
proud to be an
equal opportunity employer
Agencies:
Quantum Health does not accept unsolicited resumes or outreach from
third-parties
. Absent a signed MSA and request/approval from Talent Acquisition to
submit
candidates for a specific requisition, we will not approve payment to any third party.
Sponsorship:
Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.
#LI-HW1 #LI-Hybrid
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Company info
Quantum Health LLC.
Website : http://quantum-health.com