Who we are
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.
About the role
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 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.
Location: This position is located at our Dublin, OH campus with hybrid flexibility.
What you’ll do (Essential Responsibilities)
- 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, participating in team problem-solving methods.
- Serve as member and provider advocate by educating and guiding through the transplant process.
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Provide benefits and health information to each member so they are able to make informed health decisions. Promote the mission and core values of Quantum Health.
- Assure quality of care by adhering to therapeutic standards; measuring health outcomes against member care goals and standards; following hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.
- 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 case rate agreements, access agreements, and negotiated agreements as required by client plan design.
- Assist members and clients with wellness activities, enhanced benefits, behavioral incentives
- Other duties as assigned
What you’ll bring (Qualifications)
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Licenses/Certifications: Current and active license as a Registered Nurse in the state of Ohio, BSN preferred
- Minimum of two years clinical experience with direct patient care required
- Certification in Case Management preferred
- Outstanding computer skills including Microsoft applications
- Excellent critical thinking skills
- Possess excellent verbal and written communication skills
- Possess excellent time management skills
- Demonstrate ability to work autonomously
- Solid organ or bone marrow transplant experience desired
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Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
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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.
#LI-HW1 #LI-Hybrid
