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Clinical Nurse Specialist

1 month ago

Dublin, Ohio, United States quantum-health Full time
About the Role

The Registered Nurse (RN) Case Manager is a key member of a cross-functional care team, driven by their mutual devotion to serve others. Members view Case Managers as their patient care guides, advocating for them during some of the most challenging times of their life—facing catastrophic illness, injury or acute and chronic medical conditions.

Key Responsibilities
  • Identify members for specific case management and/or chronic condition management activities using established screening criteria.
  • Apply nursing processes to actively manage members and achieve integrated health services through coordinated service efforts.
  • Provide education and guidance to members and providers to successfully navigate healthcare complexities.
  • Maintain high quality of care by adhering to therapeutic standards, measuring health outcomes against member care goals and standards, making/recommending necessary care adjustments, and 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.
  • Document all activities specific to members, caregivers, providers, facilities and clients in appropriate databases.
  • Maintain collaborative relationships amongst health care teams through effective communication, responsiveness, building rapport and collaborative problem solving.
  • Assist members and clients with wellness activities, enhanced benefits and behavioral incentives.
Requirements
  • Licensure: Active license in good standing as a Registered Nurse (RN) in Ohio required.
  • Education: Bachelor of Science in Nursing (BSN) preferred.
  • Certification: Active Certification in Case Management (CCM) preferred.
  • Experience: 2+ years of clinical experience with direct patient care required; 5+ years preferred.
  • Experience in case management/coordination of programs and services 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 information daily.
What's in it for you
  • Compensation: Competitive base and incentive compensation
  • Coverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc 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