Transplant Case Manager Jobs (NOW HIRING)

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 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.

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, 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 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

Be a transplant 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. 

All other duties as assigned.

What you’ll bring (Qualifications)

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

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

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.

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