Sr. Transplant Coordinator (Care Coordination) - Remote

About the Role

The Senior Case Management Administrator manages high-level internal and external relationships, organ transplants, and department escalations with support from the Associate Case Management Liaison. This role requires effective communication, collaboration, and complex problem-solving skills to address issues.

Responsibilities

• Resolves department escalations by collaborating with various internal departments and vendors.
• Represents the department in cross-functional team meetings, providing strategic insights.
• Collaborates with and mentors the Associate Liaison, who serves as a backup.
• Leads and manages vendor relationships and associated process improvements.
• Provides expert support for organ transplant claims and contracts.
• Documents complex systems and processes for Case Management transplant, Specialty Rx, and elevated reviews.
• Serves as a transplant claim and contract subject matter expert, ensuring claims are priced and paid correctly.
• Provides guidance on documentation of all processes, procedures, workflows, and enhancements.
• Performs training for internal staff and external clients and vendors as needed.
• Acts as a backup for the Case Management Supervisor.
• Performs other duties as assigned.

Requirements

• Bachelor's degree in a relevant field or equivalent work experience (preferred).
• 3 or more years of related experience in healthcare/health insurance.
• Experience as a transplant coordinator is a plus but not required.
• Comfortable with advanced medical terminology.
• Organ transplant specialization and significant experience in contract negotiation.
• Strong leadership, communication, and collaboration skills.
• Intermediate-level experience with Microsoft Office, Word, Excel, Access, and PowerPoint.

Skills

• Accountability
• Analytical Thinking
• Collaboration
• Communication
• Customer Focus
• Functional Expertise
• Initiative

Work Environment

This is a remote role. The company supports a remote-friendly culture with flexibility to work from home. To ensure a smooth and efficient remote work experience, a reliable internet connection with speeds of at least 100Mbps download/25Mbps upload (via cable broadband or fiber optic) is required.

This is a standard desk role requiring extended sitting and computer work.

Benefits

• Medical, Dental, Vision, Life, and Disability Insurance
• Generous Paid Time Off
• Tuition Reimbursement
• Employee Assistance Program (EAP)
• Technology Stipend