Sr. Transplant Coordinator (Care Coordination) - Remote

POSITION SUMMARY

The Senior Case Management Administrator is responsible for the management of high-level internal and external relationships, organ transplants, and department escalations with the support of the Associate Case Management Liaison. The role requires the ability to effectively communicate and collaborate with internal and external stakeholders and the ability to apply complex problem solving to address issues.

ESSENTIAL FUNCTIONS

• Resolves department escalation by collaborating with various internal departments and vendors
• Represents the department in cross-functional team meetings, providing strategic insights.
• Collaborates with and provides mentoring to 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.
• Transplant claim and contract subject matter expert, working with Claims Team and Transplant vendors to ensure claims are priced and paid correctly.
• System documentation for Case Management transplant, Specialty Rx, and elevated reviews.
• Provides guidance on documentation of all process, procedure, and workflows and enhancements.
• Perform training to internal staff and external clients and vendors as needed.
• Back-up for Case Management Supervisor
• Other duties as assigned

EDUCATION

• Bachelor's degree in a relevant field or equivalent work experience, preferred.

EXPERIENCE AND SKILLS

• 3 or more years related experience in healthcare/health insurance.
• Experience as a transplant coordinator 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 work experience with Microsoft Office, Word, and Excel Access and Power Point software applications.

POSITION COMPETENCIES

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

PHYSICAL DEMANDS

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

WORK ENVIROMENT

• Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.