• Independently perform clinical data analysis and case management to support accurate interpretation of genetic findings, including reanalysis activities. • Establish phenotype-genotype correlations across a wide range of genetic disorders using internal resources and professional tools. • Investigates and interprets complex clinical features of genetic conditions; documents evidence and rationale for variant classification in a clear, standardized format. • Meets or exceeds productivity and error standards as assigned by team lead. • Perform clinical analysis at moderate case rate. • Perform other duties as assigned to advance team objectives.

Role Description The Case Manager Nurse plays a critical role in supporting members with complex or chronic conditions by providing proactive, telephonic case management grounded in a whole-person approach. This role focuses on reducing avoidable utilization, improving care coordination, and helping members navigate the healthcare system with confidence and clarity. As a trusted clinical resource, the Case Manager Nurse partners closely with members, providers, and health plans to assess needs, develop individualized care plans, and advocate for appropriate, cost-effective services. In addition to core case management responsibilities, this role also supports utilization review activities when needed, contributing to timely medical necessity determinations and continuity of care. This position is ideal for an experienced RN who brings strong clinical judgment, excellent communication skills, and a passion for improving outcomes for high-need populations in a collaborative, remote care management environment. This is a fully remote role. Candidates must reside in Iowa, Arizona, or Idaho. Schedule: This position works four 10-hour shifts per week and must be able to support ICM’s standard operating hours of 8:00 AM–5:00 PM Pacific Time. Specific shift times may vary based on business needs and the candidate’s time zone. What You'll Do - Patient Identification & Assessment - Identify members who would benefit from case management using claims data, referrals, and clinical records - Review referrals for clinical appropriateness using sound judgment and program parameters - Conduct comprehensive assessments of medical, behavioral, and social needs using a whole-person approach - Care Planning & Coordination - Develop individualized care plans based on patient needs, barriers, and goals - Coordinate care across the continuum, including primary care, specialists, behavioral health, and community-based resources - Facilitate clear communication between patients, providers, caregivers, and health plans to support safe transitions of care and adherence to treatment plans - Clinical Case Management & Advocacy - Provide telephonic case management for high-utilization patients with complex or chronic conditions - Use best practices in chronic disease management, motivational interviewing, and patient education - Advocate for timely, appropriate, and cost-effective care while balancing clinical judgment with plan guidelines - Support patients in navigating healthcare systems and overcoming barriers to care - Utilization Review & Medical Decision-Making - Evaluate precertification requests using evidence-based criteria and plan-specific guidelines - Review ongoing inpatient stays and make length-of-stay determinations as appropriate - Partner with Appeals & Denials and/or in-house providers to support complex clinical decisions - Documentation, Reporting & Compliance - Document all assessments, interventions, communications, and determinations thoroughly and accurately in ICM systems - Provide client-facing reports summarizing interventions, outcomes, and estimated cost savings - Ensure compliance with internal policies, regulatory requirements, and HIPAA standards - Collaboration, Leadership & Continuous Improvement - Partner with other clinical teams across ICM to remove care barriers and improve patient outcomes - Serve as a senior clinical resource, contributing to program development, cross-training, and process improvement - Stay current on best practices, regulations, and clinical guidelines related to case management - Participate in training, quality assurance initiatives, and professional development Qualifications - Active, unrestricted Registered Nurse (RN) license in good standing - Associate’s or Bachelor’s degree in Nursing - 5+ years of clinical nursing experience - Transplant (living donor, HSCT, tissue) nursing experience - Strong knowledge of chronic disease management, utilization management, and social determinants of health - Experience managing complex, high-utilization patient populations - Excellent written and verbal communication skills with empathy, professionalism, and emotional intelligence - Strong organizational skills with the ability to manage multiple priorities independently - Sound clinical judgment and confidence navigating complex or sensitive situations - Comfort working independently in a remote environment with strong accountability and follow-through - Ability to manage confidential information in compliance with HIPAA - Must reside in Iowa, Arizona, or Idaho - Ability to work four 10-hour shifts per week and support coverage during ICM’s standard operating hours of 8:00 AM–5:00 PM Pacific Time Even Better If You Have - Case management or utilization certifications (e.g., CCM, CPUR, CPHM) - Certified Clinical Transplant Nurse (CCTN) credential - Certification through the American Association of Transplant Management (AATM) - Experience in case management - Experience in a TPA or self-funded health plan environment - Knowledge of health insurance regulations and utilization management processes - Experience using medical necessity criteria and utilization review tools - Experience with EMRs and care management platforms - Multi-state licensure

Role Description The Epic Products Analyst, Senior applies advanced knowledge of healthcare operations and information technology principles to provide multifaceted direct Epic application support across the Epic software development life cycle for the design, development, implementation, testing, updating, integration, and maintenance of complex system configuration, system setup, and application tables by analyzing user, system, and application needs, and evaluating multiple alternative approaches to determine the best solution to meet the needs of the organization. Responsibilities - Conducts and attends meetings to review end-user performance, tracking and trending of issues, workflow problems, system capabilities, monitoring feedback, and potential system enhancement needs. - Performs workflow analysis, collects data, produces reports, and investigates issues in support of technical and business decision making efforts associated with the Epic software. - Assists with and coordinates the effort in change processes, content governance, and prioritization; implements approved new development, system enhancements, and releases. - Troubleshoots problems and responds to questions received from the Service Desk and end users in a timely manner. - Monitors system performance; troubleshoots and resolves application issues and system errors. - Leads the effort in the evaluation and implementation of new module releases. - Identifies, analyzes, and recommends improvements and enhancements to operational processes and system automation. - Provides status reports and updates trackers for IT/CE and facility development projects, service line expansions, break/fixes, planned upgrades, and other aspects of the IT/CE program portfolio. - Provides consulting support to Business Relationship Management teams to analyze business operations, investigate end-user preferences, and incorporate informatics best practices when making build decisions. - Creates security classification templates to provide the appropriate level of access, while ensuring the protection of patient health information. - Designs, modifies, and implements testing processes including script development, recording test results, facilitating end-user testing, testing hardware, and maintaining test environments. - Coordinates and participates in application upgrades and changes. - Monitors and collaborates with stakeholders during the integration of interfaced applications to ensure that the build and maintenance of the system and patient data integrity are not negatively impacted. - Analyzes, designs, configures, tests, and evaluates new or changed clinical/business application functionality and workflows to meet enterprise requirements; manages master file changes for new features. - Collaborates with Cogito analysts and others as needed for Epic native reports and dashboards. - Provides information and support to Instructional Designers to facilitate training development. - Ensures interoperability between Epic applications and other supporting applications. - Communicates with vendors regarding technical issues with Epic integration. - Utilizes understanding of IT trends and the practical application of existing, new, and emerging technologies to enable new and evolving business and operating models related to the Epic software. - Participates in the evaluation and selection of software product standards and services, as well as the design of standard and custom software configurations. - Analyzes the business-IT environment (run, grow, and transform the business) to detect critical deficiencies and recommend solutions for improvement, differentiation, and innovation. - Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal, state, and local standards. - Maintains compliance with all Orlando Health policies and procedures. Qualifications - Bachelor's degree in a life science, healthcare administration, computer science, information systems, informatics, or a related study. Associate’s degree and two (2) years of directly related work experience may substitute for the Bachelor’s degree. High school diploma or equivalent and four (4) years of directly related work experience may also substitute for the Bachelor’s degree. - Epic certification in the primary build application is required within six (6) months of appointment and must be maintained. - Minimum of three (3) years of experience in an information technology field is required. - Experience with Epic or other electronic health record software products is preferred. Benefits - All Inclusive Benefits (start day one) - Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees. - Forbes Recognizes Orlando Health as a Best-In-State Employer - Employee-centric: Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare.

• Assists with global benefits management including regulatory compliance, and administration of benefits programs • Proactively partners with key stakeholders in People Team (HR), Finance, and Procurement • Ensures benefits programs provide a positive employee experience with education and clear communication • Serve as a first line subject matter expert for US employee benefits queries, providing clear and accurate information • Analyze benefits data, prepare reports, and provide insights to support decision-making and identify trends • Understanding of US benefit management with an interest in expanding knowledge to other global regions in APJ and EMEA • Experience with self-funding plan management in the US • Experience with Workday Benefits module • Experience assisting with time off, ADA, and leave programs (LOA)