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RN, Registered Nurse - Transplant Case Manager
RN, Registered Nurse - Transplant Case Manager-March 2024
Dublin
Mar 30, 2026
About RN, Registered Nurse - Transplant Case Manager

  DescriptionWelcome Bonus: $2,500.00 for external candidates.Location: This position islocatedat our Dublin, OH campus with hybrid flexibility.Multistate Licensure: Quantum Health nurses must be willing and able to obtain andmaintainnursing 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 why we call ourselves Healthcare Warriors. We're committed to building diverse and inclusive teams, so if you're excited about this position, we encourage you to apply - even if your experience doesn't match every requirement.The Registered Nurse (RN) - Transplant Patient Care Guidefacilitates 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 doIdentifyand 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, facilityselection, and travel and lodging reimbursement.Perform post discharge calls.ProvideUtilization Management for Transplant listing requests foridentifiedpopulation.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 beprovidedout 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 caserate 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 andprovideupdates 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 orappropriate.All other duties as assigned.What you'll bringLicensure: Active license in good standing as aRegistered Nurse(RN) in Ohiorequired.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 carerequired;Proven clinical experience withorganand/or bone marrow transplants, 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 implementingclinical 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 andmaintainingconfidential personal information daily.What's in it for youCompensation: Competitive base pay and incentive plans.Coverage: Health, vision and dental

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