About this role

The role of the RN 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 the phone, 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, working in collaboration with internal and external customers to ensure a flawless experience for our members. The RN Care Coordinator may interface with travel coordinators and clinical contacts provider locations.

This is a 6-month contract, onsite position.

What you’ll do

• Communicate and follow-up with plan members to ensure understanding of the program while delivering exceptional customer service
• Answers the phones and responds to incoming inquiries while utilizing care center training tools
• Facilitates 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.
• Works effectively 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

What we’re looking for

• Located in or near Denver, CO and willing to work in person in the office Monday through Friday.
• 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.

As an onsite, contract position, the hourly range for this role is:

$37.00 - $43.00/hr