RN, Registered Nurse - Case Manager (hybrid WFH- Dublin, OH)
Job Description Description 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 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. The Case Manager’s clinical expertise and integrated health approach provides each unique patient with education and guidance as they navigate the complexities of health care. Location: This position is located at our Dublin, OH campus with hybrid flexibility. Rotating work from home days. No weekends or holidays What you’ll do (Essential 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. All other duties as assigned. What you’ll bring (Qualifications) Licensure and Credentialing: Must hold an active, unrestricted, and unencumbered professional license in good standing with the state board of licensure in one of the applicable clinical disciplines: Registered Nurse (RN). Where applicable, clinicians must hold a Multi-State License (MSL) issued through the relevant licensure compact (e.g., Nurse Licensure Compact for RNs). For clinicians in states that do not offer MSL, or for disciplines for which an MSL program has not been launched, employees must be willing and able to obtain and maintain additional state licenses as required to support members served by the organization. Both the MSL and individual state licenses must be obtained within 90 days of hire. Maintenance of required licensure, including timely renewal and compliance with state board regulations, is a condition of employment. The Certified Case Manager (CCM) credential from the Commission for Case Manager Certification is strongly preferred upon hire for clinicians performing case management functions. Employees hired without the certification are required to obtain the CCM within 24 months of hire or role placement. Once obtained, the employee must maintain the CCM credential in good standing and complete all continuing education and renewal requirements established by the certifying body. Failure to maintain required certification may result in removal from case management duties or other corrective action. Education: Bachelor of Science in Nursing (BSN) 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. LI-HW1 LI-Hybrid 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! What you should know Internal Associates: Already a Healthcare Warrior? Apply internally through Jobvite. Process: Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check. Diversity, Equity and Inclusion: Quantum Health welcomes everyone. We value our diverse team and suppliers, we’re committed to empowering our ERGs, and we’re proud to be an equal opportunity employer . Tobacco-Free Campus: To further enable the health and wellbeing of our associates and community, Quantum Health maintains a tobacco-free environment. The use of all types of tobacco products is prohibited in all company facilities and on all company grounds. Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate’s unique combination of experience and qualifications related to the position. Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship. Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party. Reasonable Accommodation: Should you require reasonable accommodation(s) to participate in the application/interview/selection process, or in order to complete the essential duties of the position upon acceptance of a job offer, click here to submit a recruitment accommodation request. California Employee and Job Applicant Notice of Collection of Personal Information: If you are a California resident, Quantum Health may collect personal information in connection with your application for employment and, if hired, during the course of your employment. The categories of personal information collected and the purposes for which that information is used are described in our California Employee and Job Applicant Notice of Collection of Personal Information. Please review the notice here: California Employee and Job Applicant Notice Recruiting Scams: Unfortunately, scams targeting job seekers are common. To protect our candidates, we want to remind you that authorized representatives of Quantum Health will only contact you from an email address ending in @quantum-health.com. Quantum Health will never ask for personally identifiable information such as Date of Birth (DOB), Social Security Number (SSN), banking/direct/tax details, etc. via email or any other non-secure system, nor will we instruct you to make any purchases related to your employment. If you believe you’ve encountered a recruiting scam, report it to the Federal Trade Commission and your state’s Attorney General.
