Full Time Registered Nurse Case Manager - Medical/Surgical/Musculoskeletal (MSK), Remote

About Transcarent

Transcarent and Accolade have come together to create the One Place for Health and Care, the leading personalized health and care experience that delivers unmatched choice, quality, and outcomes. Transcarent’s AI-powered WayFinding, comprehensive Care Experiences – Cancer Care, Surgery Care, Weight – and Pharmacy Benefits offerings combined with Accolade’s health advocacy, expert medical opinion, and primary care, allows us to meet people wherever they are on their health and care journey. Together, more than 20 million people have access to the combined company’s offerings. Employers, health plans, and leading point solutions rely on us to provide trusted information, increase access, and deliver care

Job Description

Accolade's Expert Medical Opinion is Recruiting for a Full Time Medical/Surgical/Musculoskeletal (MSK) Nurse Case Manager. This position is Remote and has a start date for September 8th.

Applicants will be required to work 9am to 6pm CST.

Applicants with Medical/Surgical experience and/or Post Anesthesia Care Unit (PACU) experience with are encouraged to apply. The Hiring Manager is will to train applicants who may not have Musculoskeletal experience.

Role overview:

As an Medical/Surgical/Musculoskeletal (MSK) Nurse Case Manager:  you will be reporting to a Nursing Manager, you will play a crucial role as a reliable resource for our members requiring ongoing support of complex or chronic health conditions.  Leveraging your clinical expertise and applying Accolade’s core value of genuine care for members, telephonically you will conduct thorough assessments of members’ health concerns, prioritize medical needs, facilitate and manage expert medical opinions, provide specialty care navigation and follow up guidance.

A day in the life…

Accolade Nurse Case Managers are entrusted with providing information to our diverse population of members that empowers them in making informed health decisions.  We partner with our members in various ways (via telephone and digital), and apply critical thinking measures to achieve the following:

• Meet queue expectations by managing and adhering to scheduled nurse intake appointments, ensuring timely and efficient service for all members.

• Conduct clinical and behavioral assessments to understand members’ holistic needs and advocate for appropriate care.

• Draft medical histories and identify consultation goals. Accurately enter all case details into Case Management Software, ensuring real-time, HIPAA-compliant data integrity.

• Identify necessary medical records for collection, collaborate with Health Information Technicians to organize them, and determine the most suitable panel specialist for each case.

• Coordinate and schedule video or phone consultations, arrange support personnel, and troubleshoot potential issues beforehand.

• Review and share specialist notes with members and facilitate local provider recommendations as needed.

• Conduct follow-up calls to ensure members reach their health goals and provide additional support as needed.

• Facilitate local referrals to providers, agencies, or facilities, and collaborate with interdisciplinary care teams to maintain continuity of care.

• Identify and document cases with successful outcomes for potential testimonials to highlight the impact of the Expert Medical Opinion service.

• Engage members through inbound and outbound calls, educating them on Accolade services and directing them to relevant internal programs or employer-sponsored benefits, like virtual primary care and complex case management.

• Provide specialty care navigation to members, guiding them through the complexities of managing their health for improved health outcomes.

• Provide education, high-touch coaching, referrals, and network steerage tailored to meet the unique needs of each member.

• Assist members with all specialty conditions, including those who are symptomatic or unsure of where to start their diagnostic work-up and treatment.

• Coach members on the next steps in their diagnosis and treatment plans, including formulating questions for local providers.

• Participate in monthly Care Team meetings, contributing insights and promoting a collaborative care environment.

What we are looking for… 

Requirements:

• Bachelors Science of Nursing (BSN) with Minimum of 3-5 years of Clinical Experience; or Associates Degree of Nursing (ADN) with Minimum of 5-6 years of Clinical Experience

• 1 Year of telep