Registered Nurse

The Registered Nurse I, Expert Medical Opinion reports to the Manager, Clinical Operations and supports members through their Expert Medical Opinion journey.

In this role, the RN I operates within a defined functional scope focused on expert medical opinion case intake, clinical coordination, member support, and case progression. The RN I is responsible for executing established workflows, maintaining accurate documentation, and supporting members through complex or chronic health concerns 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. Hours for this role are 9a-6p CST.

What you'll do

As a Registered Nurse I, Expert Medical Opinion, you will execute core EMO workflows within your assigned function, applying clinical judgment, operational processes, and documentation standards to support members and internal care teams. You will work within established guidelines while building proficiency, consistency, and confidence in your role.

Expert Medical Opinion Coordination

• Conduct clinical intake and assessment to understand members' health concerns, symptoms, history, and consultation goals.
• Perform clinical and behavioral assessments to understand members' holistic needs and advocate for appropriate care.
• Draft clear, accurate medical histories and identify the key questions and objectives for expert consultation.
• Identify required medical records and clinical documentation needed for case completion and partner with internal teams to support timely collection and organization.
• Determine appropriate case routing and help identify the most suitable panel specialist based on established criteria.
• Coordinate and schedule video or phone consultations, confirm member readiness, and troubleshoot issues in advance of scheduled appointments.
• Review specialist recommendations and notes, share appropriate next steps with members, and reinforce understanding of the consultation outcome.
• Conduct follow-up outreach to support members in progressing toward their care goals and to address additional questions or barriers.
• Facilitate referrals to local providers, agencies, or facilities as needed and support continuity of care across the member journey.
• Provide specialty care navigation for members managing complex or chronic conditions, including members who are symptomatic or unsure where to begin their diagnostic workup or treatment planning.
• Educate members on next steps in diagnosis and treatment, including how to prepare for conversations with local providers.
• Provide high-touch education, coaching, referrals, and network steerage tailored to the needs of each member.

Member Support and Case Operations

• Meet queue expectations through timely, efficient case handling.
• Engage members through inbound and outbound communication, providing education on available services and connecting them with relevant internal programs and benefits when appropriate.
• Maintain accurate, timely, and HIPAA-compliant documentation of all case activity, clinical details, and member interactions in internal systems.
• Track case status and advance members through established workflows to support timely completion of the expert medical opinion process.
• Identify and escalate clinical risks, barriers to case progression, or workflow issues as appropriate.
• Partner with interdisciplinary care teams to maintain continuity of care and coordinate support across functions.
• Identify and document successful case outcomes in accordance with internal processes and quality expectations.
• Participate in team meetings and care team discussions, contributing insights and supporting a collaborative care environment.

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.
• Demonstrate flexibility, sound judgment, empathy, and professionalism in a fast-paced, evolving healthcare environment.

Education Requirements

• BSN or RN with bachelor's degree

o Minimum of 3-5 years of Clinical Experience; or

• AAS or ADN degree

o Minimum of 5-6 years of Clinical Experience

What we're looking for

• Registered Nurse with active multi-state licensure.
• Minimum of 1 year of telephonic nursing experience.
• Strong written, verbal, and interpersonal communication skills with a service-oriented, member-first mindset.
• Proficiency in navigating multiple technologies and systems, including EMRs and other professional technology platforms, while multitasking effectively across listening, typing, and member interaction.
• Excellent organization, critical thinking, and problem-solving skills.
• Ability to remain focused, flexible, and effective in a dynamic healthcare environment.
• Demonstrated empathy, strong listening skills, and the ability to support members through complex or emotionally challenging health situations.
• Commitment to continuing education and ongoing professional development.

Nice to have

• Minimum of 2-3 years of direct patient care or case management experience.
• Experience in one or more of the following: specialty clinic or office setting, utilization management, triage, managed care, or discharge planning.
• Familiarity with health plans, population health, and value-based healthcare programs.
• Experience supporting members with specialty conditions, complex diagnoses, or chronic health concerns.
• Experience collaborating across interdisciplinary care teams and operational partners.
• Ability to write clear, concise clinical summaries and case documentation.

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. 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.