As a licensed clinical professional, such as a Registered Nurse (RN), Licensed Practical Nurse (LPN) or Social Worker (LSW/LISW), you’ll leverage your unique expertise to drive quality clinical outcomes for our members from our beautiful headquarters in Dublin, Ohio.
This practice setting offers experienced clinicians a less physically demanding environment with no direct patient care. And unlike working in a hospital or home care setting, you’ll be free on weekends and holidays.
Some organizations call this a Case Manager, Nurse Navigator or Care Coordinator. At Quantum Health, we call it a Personal Care Guide (PCG). As a PCG, you’ll serve as a primary clinical resource to members navigating a variety of healthcare events and diagnoses by using established screening criteria and recommending care adjustments. You’ll partner with Pod leaders and clinical staff to ensure consistency of clinical activities. You’ll also triage member questions and act as a role model and coach.
Our Pre-Certification Nurses review and process medical service requests and guide the administrative processes related to admissions, discharges and more. Appeals Nurses advocate for our members when care is denied and work collaboratively to ensure proper care is provided. Working in Pre-Certification and Appeals, you’ll ensure the administrative details of our members’ healthcare journeys are accounted for.
No healthcare journey is routine, and our members deserve the very best. That’s why we rely on nurses with experience in behavioral health, chronic condition management, high risk pregnancies, oncology, transplants, and more. Practicing in our clinical specialty program means you’ll guide our members who need your expertise the most as they navigate life-altering experiences.
Practicing nursing in Utilization Review (UR), you’ll review and assess inpatient medical service requests for pending and previous cases. Collaborating with internal and external partners, you’ll compile clinical documentation and review medical services on behalf of our members to ensure they receive appropriate care.
For those situations that require an increased scope of practice, we rely on our specialized team of Pharmacists, Physicians and our Chief Medical Officer. We’re always looking for specialized clinical talent. If you can see yourself practicing here, we’d love to connect.
As a clinician on our team, your contributions are vital to our members’ satisfaction and our success. Our benefits are designed to reward you for the difference that you make every day.