Infusion Case Manager RN

Lucent Health; Nashville (TN); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Unlimited Paid Time Off

10 Paid Holidays

Medical, Dental, Vision

Job summary

Lucent Health is seeking an Infusion RN to join our Clinical Operations team, supporting the home infusion site of care program. You will evaluate patient eligibility for home infusion, discuss transitioning from facility-based care to in-home care, and coordinate with the in-network provider to ensure a safe, cost-efficient infusion experience for self-insured employer clients.

You will collaborate with the care management team to monitor patients after transition, schedule initial visits,

Qualifications

• Active, unrestricted multi-state RN license.
• At least 5 years clinical experience.
• Experience in infusion therapy, home infusion, or IV therapy preferred.
• Credentials such as CRNI, CCM, CRRN, OCN, or other pertinent certifications (preferred).
• Excellent written, telephone, and computer skills.
• Positive, proactive, team-oriented approach with ability to work independently in telephonic care management environment.

Responsibilities

• Conducts medical review of plan participants to determine clinical eligibility for home infusion therapy based on diagnosis, treatment plan, and plan benefit design.
• Calls patients directly to discuss clinical and practical benefits of home infusion, addressing safety, convenience, and cost questions.
• Educates patients and caregivers on the home infusion process and in-network providers.
• Sets up and schedules initial home infusion appointments with in-network providers.
• Facilitates transition of care from current site of service to in-home setting.
• Verifies clinical documentation, physician orders, and payer authorizations prior to initiating transition.
• Communicates with in-network provider to confirm readiness, delivery logistics, and nursing visit schedules.
• Monitors patients post-transition for tolerance and adverse events, escalating as needed.

Skills

RN license

Infusion therapy

Communication skills

Care coordination

Multistate licensure

Education

Nursing degree (BSN/ASN)

Tools

EHR systems

Telehealth platforms

Microsoft Office

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.

ROLE SUMMARY

We are looking for an Infusion RN to join our Clinical Operations team, supporting the home infusion site of care program. The Infusion RN will conduct medical review of plan participants’ eligibility for home infusion therapy, engage patients directly to discuss transitioning from a facility-based setting to in-home care, and coordinate the full transition of care with the in-network home infusion provider delivering the infusion services. This role partners cross-functionally with the care management team to ensure a safe, well-coordinated, and cost-effective infusion experience for Lucent Health’s self-insured employer clients.

KEY RESPONSIBILITIES

• Conducts medical review of plan participants to determine clinical eligibility for home infusion therapy based on diagnosis, treatment plan, and plan benefit design.
• Calls patients directly to discuss the clinical and practical benefits of home infusion versus a facility-based setting, addressing questions about safety, convenience, and cost.
• Educates patients and caregivers on the home infusion process, including the role of the in-network home infusion provider who will deliver infusion services in the home.
• Sets up and schedules the initial home infusion appointment with the in-network provider, aligning with the patient’s treatment timeline and clinical urgency.
• Facilitates the transition of care from the patient’s current site of service (e.g., hospital, infusion center, physician’s office) to the in-home setting.
• Verifies that all necessary clinical documentation, physician orders, and payer authorizations are in place prior to initiating the transition.
• Communicates with the in-network home infusion provider to confirm patient readiness, delivery logistics, and nursing visit schedules.
• Monitors patients following transition to home infusion, including therapy tolerance and any adverse events, escalating concerns to the clinical team as needed.
• Identifies and helps resolve barriers to home infusion (e.g., caregiver availability, home environment, authorization delays) in partnership with the care team.
• Conducts holistic patient assessments, develops individualized care plans, and sets measurable goals consistent with benefit plan design.
• Advocates for the patient and maximizes benefit dollars by researching costs of services and in-network resources.
• Evaluates the effectiveness of the care plan on an ongoing basis and documents all eligibility reviews, outreach, and transition activities in a clear, objective, and timely manner.
• Other duties as assigned

QUALIFICATIONS & PROFESSIONAL LICENSURE REQUIREMENTS

• Registered Nurse with a minimum of 5 years Clinical Experience
• Experience in infusion therapy, home infusion, or IV therapy strongly preferred
• Knowledge of home infusion site-of-care transitions and payer/benefit considerations for infusion services
• Credentials such as CRNI (Certified Registered Nurse Infusion), CCM, CRRN, OCN, or other pertinent certifications (preferred)
• Active, unrestricted multi-state RN license
• Excellent written, telephone, and computer skills, with strong time management and organizational skills
• Positive, proactive, team-oriented approach, with the ability to work independently in a telephonic care management environment

WHAT WE PROVIDE

• Unlimited Paid Time Off
• 10 Paid Holidays
• Medical, Dental, Vision, and other ancillary benefits

COMPANY CULTURE

At Lucent Health, our success is built on employees who are honest, ethical and hardworking. We communicate transparently, act with integrity, and hold ourselves accountable for our work and decisions. We treat colleagues, clients and partners with fairness, respect and confidentiality. And we bring consistency, initiative and adaptability to everything we do, taking ownership of challenges and going the extra mile when it counts.

Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.