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Job Details

Registered Nurse Transplant Personal Care Guide

Company name
Quantum Health LLC.

Location
Dublin, OH, United States

Employment Type
Full-Time

Industry
Healthcare, Nursing

Posted on
Jun 11, 2023

Apply for this job






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

Apply

Company info

Quantum Health LLC.
Website : http://quantum-health.com

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