Registered Nurse I, Case Management

As a Registered Nurse I, Case Manager, you will serve as a trusted resource for our members, providing clinical expertise in triage, healthcare navigation, and advocacy. Leveraging your skills and compassion, you will exercise genuine care by assessing members’ health concerns, prioritizing medical needs, and providing evidence-based recommendations, ensuring members receive timely and appropriate care. Your role is critical in guiding members through their healthcare journey while addressing disparities to support marginalized populations. Together, we work to achieve positive outcomes by empowering members to take the right steps in their healthcare journey.

At Transcarent, we foster a growth mindset, encouraging continuous learning and collaboration. You will enhance your clinical knowledge while partnering with our care teams to deliver exceptional support, including navigating benefit offerings and specialized programs.

What you’ll do

• Empower Members: Provide education to help members confidently navigate the complex healthcare system, building trust and fostering connections to appropriate clinical programs and services.

• Conduct Assessments: Perform telephonic, holistic clinical assessments to identify and prioritize members’ needs addressing their questions and concerns.

• Support Whole-Person Health: Address members' needs across both medical and behavioral health, remaining comfortable and confident supporting members with a variety of diagnosis across the continuum.

• Educate and Refer: Offer clear, evidence-based education on healthcare decisions, referring members to Transcarent’s internal programs and trusted partnerships, such as virtual primary care, expert second opinions, and complex case management. Leverage trusted partnerships within Transcarent's ecosystem to promote optimal clinical outcomes for members. Collaborate with Transcarent’s program partners specializing in telemedicine, diabetes management, physical therapy, gender-diverse support, and behavioral health.

• Guide Next Steps: Prepare members for upcoming healthcare events by educating them on procedures, medications, testing, provider visits, and treatment options.

• Foster Relationships: Maintain follow-up support to ensure members feel informed and cared for throughout their healthcare journey.

• Ensure Compliance: Maintain data integrity, compliant to HIPAA guidelines, ensuring accuracy in real time member records, including assessments, interventions, and outcomes.

What we’re looking for

Required:

• Bachelor's degree in nursing (BSN) or equivalent.

• Active, unrestricted RN license; Compact (NLC) license.

• Minimum of 3 years of recent clinical experience in direct patient care.

• Strong clinical acumen, critical thinking, and communication skills.

• Technological fluency, including the ability to navigate multiple systems simultaneously.

• Hybrid work expectations for nurses near a Transcarent office; occasional travel for remote employees.

Preferred:

• Experience with telephonic triage and related protocols.

• Knowledge of medical benefits, insurance claims processes, and healthcare coordination.

• Direct patient care experience in medical/surgical, oncology, maternity, behavioral health, ER, and/or homecare settings.

• Dedication to professional development and staying current in nursing practices.

• Empathetic, client-focused approach to healthcare advocacy.

Additional Information:

• This role involves telephonic and digital interactions with members, requiring strong communication skills, organization, and the ability to work collaboratively in a team-oriented environment.

• You will be integral in advocating for members' healthcare needs and ensuring they receive personalized care and support throughout their healthcare journey.

• Flexibility to work various shifts, including nights, weekends, and holidays as needed.

Who we are

Transcarent is the One Place for Health and Careᵀᴹ, bringing medical, pharmacy, and point solutions together with the WayFindingᵀᴹ experience, the first and only generative AI-powered health and care platform for health consumers.

Our WayFinding experience, paired with transparent and consumer-driven pharmacy care, 2nd.MD expert medical opinions, and virtual primary care, works seamlessly with comprehensive Care Experiences – Cancer Care, Surgery Care, and Weight Health – to support people with all of their health needs, simple or serious. More than 1,700 employers and health plans rely on us to provide information, guidance, and care, empowering health consumers with more choice, an experience they love, access to higher-quality care, and lower costs for 21 million Members. For more information, visit transcarent.com, and follow us on LinkedIn.

At Transcarent, our values guide everything we do:

• People First: We prioritize our Members, clients, and each other in every decision

• Care: Every decision starts with improving health and care for our Members

• Resilience: We push boundaries and take the uncharted path to change an industry

• Results: We take ownership, solve with speed, and deliver for our people and each other

• Humble and Human: We lead with humility, bring fun to tough moments, and go further together

Total Rewards

Individual compensation packages are based on a few different factors unique to each candidate, including primary work location and an evaluation of a candidate’s skills, experience, market demands, and internal equity. Salary is just one component of Transcarent's total package. All regular employees are also eligible for the corporate bonus program or a sales incentive (target included in OTE) as well as stock options.

Our benefits and perks programs include, but are not limited to:

• Competitive medical, dental, and vision coverage

• Competitive 401(k) Plan with a generous company match

• Flexible Time Off/Paid Time Off, 13 paid holidays

• Protection Plans including Life Insurance, Disability Insurance, and Supplemental Insurance

• Mental Health and Wellness benefits

Transcarent is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out!

Research shows that candidates from underrepresented backgrounds often don’t apply unless they meet 100% of the job criteria. While we have worked to consolidate the minimum qualifications for each role, we aren’t looking for someone who checks each box on a page; we’re looking for active learners and people who care about disrupting the current health and care with their unique experiences.