Nurse Case Manager

Mainstay Medical

Mainstay Medical is a medical device company focused on marketing an innovative
implantable neurostimulation system, ReActiv8®, for people with disabling
chronic mechanical Low Back Pain. The company is headquartered in Dublin,
Ireland, with subsidiaries operating in Ireland, the United States, Australia,
Germany, and the Netherlands.

The Role

Oversees the coordination and execution from patient identification to implant.
Case Managers are responsible for empathetic communication, education, and
management of implant logistics for patients, ensuring a smooth and efficient
path to implantation of ReActiv8®. Case Managers collaborate closely with
field-based teams on patient pipelines. This individual will take ownership and
manage the ReActiv8® patient funnel and provide timely and accurate updates to
multiple team members. The incumbent will be a professional who demonstrates
strong business acumen and collaborates effectively with field-based teams,
providing timely, and accurate documentation in a web or cloud-based system. 

Position Responsibilities

* Acts as a subject matter expert on ReActiv8®, conducts clinical review of
patient’s medical records, assuring complete and quality case documentation
for all levels of review.
* Provides education for patients and family members on the ReActiv8® system,
therapy and the prior authorization process. 
* In conjunction with the Therapy Managers, will oversee patients progress to
implant, navigating, evaluating and driving the most effective pathway to
approval, while making necessary adjustments. 
* Posses strong understanding on the need for patient documentation and will
log all interactions and outcomes accurately within a cloud or web-based
system.
* Acts as a liaison between physicians, their office staff and patients,
leveraging empathy, warmth and a customer service mindset in all interactions
including field teams when providing timely case updates.
* Advocates for patients needs and preferences, while always respecting patient
confidentiality. 
* Facilitates communication and coordination amongst team members, facilitating
regular pipeline calls to ensure cases are progressing forward towards pull
through.
* Develops, implements, and manages a plan of action for each patient in
collaboration with the Therapy Manager (TM) and patient. Demonstrates strong
documentation skills for each plan of action within a web or cloud-based
system.
* Regularly collaborates with team and field teams to ensure patient barriers
are removed or addressed, and internal and external resources are aligned to
facilitate the implant process.
* Works with patients and care providers to ensure quick and easy access to
surgical scheduling, and implantation of ReActiv8®. 
* Manages multiple priorities and deadlines simultaneously, while handling a
high patient volume. 
* Ensures compliance with policies, in particular patient confidentiality
(HIPAA) in all Mainstay Medical interactions. 
* Provides clear and effective communication via multiple methods (in-person,
in-writing, on the phone and in front of small and mid-sized audiences). 
* Demonstrated ability to work independently as well as part of a team that
values collaboration and openness while balancing workloads to ensure
patients are always prioritized.
* Strong acumen and desire to critically evaluate caseloads, bringing forward
insights and opportunities via KPIs.
* Ability and willingness to shift work schedule to a different time-zone as
business dictates. 
* Willingness to assist others in Commercial Operations with patients and/or
special projects as requested from both inside and outside the department.

Qualifications

* Ability and willingness to shift work schedule to a different time-zone as
business dictates. 
* Ability to travel up to 10% of the time. 
* Education level: BSN, RN, or equivalent required.
* Experience in care coordination, case management, and some knowledge of
insurance- required.
* Experience in direct patient care, in medical office or hospital setting with
coding and prior authorization experience. 
* Knowledge of health insurance industry practices/functions to include
Medicare, Medicaid, and all types of commercial and managed care
organization’s coverage policies.
* Skilled at patient engagement and interaction; experience in patient
education.
* Strong organizational skills with a keen eye and attention to detail.
* Clear written and verbal communication skills—both in-person, in-writing and
over the phone. 
* Strong abilities in Microsoft Word, Outlook, Excel, PowerPoint.
* 3+ years of experience working with a cloud or web-based documentation system
required.
* Strong problem solver and capable of finding solutions to challenges or
process gaps.
* Demonstrated interactions of maintaining a caring, empathetic, and
patient-centric approach in all interactions.

The salary range for this position is $82,000 to 110,000/year; however, base pay
offered will take into account a range of factors, including job-related
knowledge, skills, and experience. The total compensation package includes a
range of medical, dental, vision, financial, and other benefits, as well as
equity.

Mainstay Medical is an Equal Opportunity Employer. All qualified applicants will
receive consideration for employment without regard to gender, race, color,
religious creed, national origin, age, sexual orientation, gender identity,
physical or mental disability, and/or protected veteran status. Mainstay Medical
participates in E-Verify.