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RN Specialist Transplant Job

Date: Jan 2, 2019

Location: Eagan, Minnesota, US, 55122

Company: Blue Cross and Blue Shield of Minnesota

About Blue Cross



At Blue Cross and Blue Shield of Minnesota, we are developing industry-leading strategies every day that make a healthy difference in people’s lives. Blue Cross has a legacy of improving health through innovation because we believe that everyone should have the opportunity to live the healthiest life possible. Chartered in 1933 as the state’s first health plan, we’ve been serving the health care needs of Minnesotans for more than 80 years.



Blue Cross supports you with competitive pay and a comprehensive benefits package. Many Employee Resource Groups are active in the company, promoting inclusion and helping us meet the diverse needs of our workforce and our members. Join us, and enjoy a work environment where all employees are respected and valued — a workplace honored with a perfect score on the Human Rights Campaign Corporate Equality Index for 2017. Find your place at a company that cares.



 


Description Summary

This exciting role requires a clinician that thinks outside the box and truly desires to make a difference in the lives of members living with end-stage renal disease (ESRD) as well as those going through the transplant experience.  Utilizing key principles of case management, the RN Specialist will work closely with an interdisciplinary team to ensure members have an effective plan of care that leads to optimal outcomes. Leveraging transplant expertise, the RN specialist will work closely with the member and their family to avoid unnecessary hospitalizations, optimize site of care when transplant occurs and ensure evidence based treatment is being applied. This position will primarily focus on renal transplant but will also encompass all other solid organ and bone marrow transplants as well.


Accountabilities


  1. Receives referral and leverages clinical and condition pathway knowledge for outreach stratification

  2. Conducts clinical assessments with members and providers; gathers, analyzes, synthesizes and prioritizes member needs and opportunities.

  3. Collaborates and communicates with the health care team; e.g. member, family, designated representative, health care provider on a plan of care that produces positive clinical results and promotes high–quality, cost effective outcomes.

  4. Identifies relevant BCBSMN and community resources and facilitates program and network referrals.

  5. Monitors and evaluates plan of care over time.

  6. Ensures member data is documented according to BCBSMN application protocol and regulatory standards.

  7. Maintains outstanding level of service at all points of customer contact.

  8. Understands divisional goals of assigned condition and market segment(s) including clinical and service availability

  9.  Collaborates and coordinates with team members to facilitate day to day functions and enhance the overall operation of the department.

  10. 10 CEU’s per year within specialty area for knowledge base maintenance OR current certification in clinical specialty. Based on learnings, provide educational sessions for care management teams

  11. Engage providers telephonically in reviewing and understanding treatment plans, including alignment with benefits and medical reimbursement policies to facilitate optimal treatment plans, care coordination, and transition of care between settings. 


Requirements


  • Registered nurse with current MN license and with no restrictions

  • 4 years relevant clinical care experience including renal transplant

  • 1 years of managed care experience; e.g. case management/health coach, utilization management and/or auditing experience (may be included in the 4 years relevant clinical experience)

  • Excellent communication skills

  • Excellent conceptual thinking skills

  • Excellent relationship management skills

  • Excellent organizational skills

  • Computer application proficiency

  • Flexibility to work varied hours


Preferred Requirements


  • Outstanding telephonic skills   

  • Transplant certification (CPTC, CCTC, CCTN)


FLSA Status

Exempt


Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association


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