| Location | IL |
This role supports members through their Transcarent Surgery Care journey and combines foundational clinical judgment, member navigation, and operational coordination to ensure members receive timely, accurate, and high-quality support.
In this role, the RN I operates within a defined functional scope, either Surgery Care Coordination or COE Engagement. The RN I is responsible for executing established workflows, maintaining accurate documentation, and supporting case progression under defined standards. Through consistent application of Transcarent workflows and quality expectations, the RN I contributes to a seamless member experience.
The RN I upholds Transcarent's mission, values, and quality by delivering clinically appropriate guidance, clear communication, and reliable follow-through while developing the skills needed to take on expanded responsibility over time.
What you'll do
As a Registered Nurse I, Surgery Care, you will execute core Surgery Care workflows within your assigned function, applying clinical judgment, operational processes, and documentation standards to support members and provider partners. You will work within established guidelines while building proficiency, consistency, and confidence in your role.
Care Coordination
Conduct clinical intake, ensuring accurate understanding of symptoms, history, risk factors, and surgery readiness
Assess member appropriateness for the Surgery Care program and identify appropriate COE placement in accordance with established criteria
Provide clear education to members regarding program requirements, next steps, timelines, and expectations
Coordinate the full case pathway with support from internal partners, including scheduling, benefits, pre-authorization needs, and facility coordination
Obtain, review, and validate required clinical documentation, forms, clearances, tests, consult notes, imaging, and consents
Track case status and advance members through established workflows
Maintain accurate and timely documentation of all interactions and decisions within internal systems
Identify and escalate clinical risks, barriers, or workflow issues as appropriate
COE Engagement
Serve as a clinical point of contact for assigned COEs, ensuring efficient communication from referral through post-op follow-up.
Prepare and submit complete referral packets for COE review, confirming case receipt and monitoring review status.
Obtain key updates including acceptance/denial decisions, consult dates, required next steps, and surgical approval items.
Review and validate Case Approval Forms (CAF), following up on missing elements such as codes, TRDs, or facility information.
Gather post-consult recommendations, clarify next steps, and ensure all requirements for surgical approval are met.
Maintain accurate COE account records, contacts, and referral data within Salesforce.
Partner with Clinical, PRE, AE, Medical Records, Scheduling, Benefits, Travel, Provider Relations, and Operations teams to resolve barriers and expedite care.
Collaborate with internal clinical programs to ensure alignment and continuity of care.
Participate in weekly operations meetings with COEs to support case progression and gain familiarity with provider workflows
Serve as a resource to colleagues for routine case questions within assigned functional area
General
Identify and escalate workflow gaps and proactively partner with leadership and peers to implement improvements
Contribute to quality assurance efforts by evaluating clinical documentation, identifying issues, and escalating as appropriate.
Uphold HIPAA, professional standards, and organizational policies while delivering clinically appropriate guidance.
Education Requirements
BSN or RN with bachelor's degree
AAS or ADN degree
What we're looking for
Registered Nurse with active multi-state licensure.
Clinical experience in surgery or a related specialty preferred.
Strong written, verbal, and interpersonal communication skills with a service-oriented, member-first mindset.
Proficiency in navigating multiple systems (Microsoft Office, EMRs, contact center platforms, Salesforce).
Excellent organization, critical thinking, and problem-solving skills.
High attention to detail and reliable follow-through across a high-volume caseload.
Ability to remain focused, flexible, and effective in a fast-paced, evolving environment.
Demonstrated adaptability to new workflows, tools, and technologies.
Are available to work a M-F schedule, between 9a-5:30pm CST (10:00a-6:30p EST/ 8:00a-4:30p MST/ 7:00a-3:30p PST).
Nice to have
Experience in multidisciplinary teams (care coordination, UM/CM, navigation, COE programs).
Experience supporting members through high-stakes or emotionally complex clinical decisions.
Skill in member-focused communication, motivation, and de-escalation.
Familiarity with clinical documentation standards and ability to write clear, concise case notes.
Experience collaborating across clinical, operational, and provider-facing teams.
Comfort working in rapidly scaling or changing healthcare environments.
Experience presenting clinical summaries or discussing clinical pathways in team settings.
Who we are
Transcarent is the One Place for Health and Care, bringing medical, pharmacy, and point solutions together with the WayFinding 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 - this role is budgeted at $90,000. 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.