The Role

The role of the Registered Nurse, Care Coordinator is to work with members to introduce, coordinate, and guide members through their Transcarent experience. In this caseload carrying role, you will have an opportunity to improve members’ lives.  

Responsibilities include answering inbound calls, educating members on their benefits, uploading documents into the computer system, coordinating members surgical care with providers, obtaining precertification authorizations, requesting and reviewing medical records, and working in collaboration with internal and external customers to ensure a flawless experience for our members. The Registered Nurse, Care Coordinator may interface with travel coordinators and clinical contacts provider locations. 

This is a 6-month contract, remote position.  What you’ll do

• Communicate and follow-up with plan members to ensure understanding of the program while delivering exceptional customer service  
• Answer the phone and respond to incoming inquiries while utilizing care center training tools  
• Facilitate patients successfully through the surgery review process, exceeding expectations while meeting the program metrics  
• Efficiently and effectively manages a case load across a variety of clients and surgical categories  
• Coordinate the scheduling and approval process from the initial request for surgery to patient placement  
• 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. 
• Obtain the necessary information – demographic, financial, clinical and other pertinent data to complete referral process  
• Maintain and update application with current data, pertinent information, and status of cases 
• Collaborate with providers, clinics and facilities, and various levels of management to effectively resolve issues. Obtain pre-authorizations. 
• Work with other supporting operational roles and internal departments, to coordinate the member’s case 
• Effectively address and resolve patient barriers to utilize the benefit including working with members to address program questions 
• Maintain confidentiality and knowledge of HIPAA regulations 
• Demonstrate Transcarent core values 
• Comply with company policies 
• Be willing and available to work overtime as needed 

Qualifications

• Available to work: Monday - Friday, 9:30am - 6:00pm MST or 10:30am - 7:00pm MST 
• Registered Nurse with active, multistate licensure required
• Bachelor of Science in Nursing (BSN) required
• A minimum of 5 years clinical acute care experience as a practicing RN preferred
• Experience in surgery preferred
• Proficient in data entry, Microsoft Office, and contact center-style phone systems
• Excellent customer service, written and verbal communication and interpersonal skills
• A “delight the customer” attitude
• Strong organizational, critical thinking and problem-solving skills 
• Strong attention to detail and follow-through 
• Project management-type skills; prior experience managing a high-volume caseload 
• An ability to focus in a high energy atmosphere 
• Openness and understanding that dynamic environments include change, and welcoming that change with a positive attitude 

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.