The Role

The Registered Nurse Clinical Specialist reports to the Director, Clinical Operations of Care Support Services and is responsible for guiding members through their Transcarent experience in partnership with Transcarent’s Care Coordinators. This role also supports quality assurance and improvement efforts and operations related to our Centers of Excellence (COE) program in accordance with the Transcarent Quality Tenets. The Registered Nurse Clinical Specialist will reflect the mission, vision, and value statements of Transcarent to internal departments and external plan sponsors, providers, and partners. 

What you’ll do Support the Care Support Services team with clinical subject matter expertise and guidance relating to individual cases and in broader strategy and processes. This includes direct support to Plan Members.

• Partner with the Care Support Services Team to manage a caseload efficiently and effectively across a variety of clients and all clinical categories. 
• Supports members to introduce, coordinate, and guide members through their Transcarent experience. 
• Work effectively with other supporting operational roles and internal departments, to coordinate the member's case. 
• Effectively address and resolve Member barriers to utilizing the benefit including addressing program questions and collecting medical records in a timely and accurate manner to ensure an expedited process. 
• Work with cross functional teams to develop new or update existing quality measures, protocols, processes, and policies to minimize risk and ensure compliance. 
• Work collaboratively with our COE facility and provider partners in support of achieving the highest quality experience for our Members. 
• Support the Provider Relations team with guidance relating to COE facilities and providers for targeting and participation. 
• Support the operational needs of the COE program from a clinical perspective including monitoring and support for member complications. 
• Lead a cohort of Care Coordinators to ensure cases are effectively progressing through to completion accurately. 
• Other duties as assigned. 

Qualifications

• Available to work Monday - Friday, 11:00am - 7:00pm MST.
• Bachelor of Science in Nursing (BSN) required. 
• Active Nurse Licensure Compact (NLC) multi-state license is required.
• A minimum of 5 years clinical acute care experience as a practicing RN preferred. 
• Experience in surgery preferred. 

Nice to have 

• Flexibility - Openness and understanding that dynamic environments include change, and welcoming that change with a positive attitude. 
• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. 
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. 
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. 
• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. 
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. 

The Company

Transcarent is the One Place for Health and Care. We cut through complexity, making it easy for people to access high-quality, affordable health and care. We create a personalized experience tailored for each Member, including an on-demand care team, and a connected ecosystem of high-quality, in-person care and virtual point solutions. Transcarent eliminates the guesswork and empowers Members to make better decisions about their health and care.

Transcarent is aligned with those who pay for healthcare and takes accountability for results – offering at-risk pricing models and transparent impact reporting to ensure incentives support a measurably better experience, better health, and lower costs.