Job Description:
Clinical Case Specialist (Solventum)
3M Health Care is now Solventum
At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients’ lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.
We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.
The Impact You’ll Make in this Role
As a clinical case specialist, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by:
· Assists in orders for urgent placement for patients discharging from acute facilities
· Assists in determining patient qualifications for medical necessity based on payor coverage criteria
· Assists in resolution of clinical issues related to the billing process
· Interpret clinical documentation to identify required payor criteria that leads to the identification of correct diagnosis codes
· Interfaces with internal and external departments to ensure that Solventum’s clinical guidelines are always in the forefront of decisions
· Provides recommendations on Vacuum Assisted Closure (VAC) placements that are failing to demonstrate wound healing or improvement
· Evaluates and generates payer appeals for adverse determination by commercial payers. (MCO)
· Serves as a resource for nonclinical staff and conducts necessary training as needed
· Analyzes medical necessity cases to advise on trends and patterns
· Validates medical necessity for all payor types
· Open communication with supporting teams (Order Fulfillment, Billing Verification, Wound Care Center, Wound Documentation Team and Sales Field Teams) across the organization and external customers as appropriate
· Communicates concerns and issues and escalates as appropriate
Provides specialized professional and technical support to Solventum customers, distributors, and sales teams. Develops expertise in assigned products and projects while building knowledge of the business, organization, and customer base.
Your Skills and Expertise
To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications:
Additional qualifications that could help you succeed even further in this role include:
Work location:
· Hybrid Eligible
Relocation Assistance: Not be authorized
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).
Supporting Your Well-being
Solventum offers many programs to help you live your best life – both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope.
Solventum es un empleador que ofrece las mismas oportunidades. Solventum no discriminará a ningún solicitante de empleo por razones de raza, color, edad, religión, sexo, orientación sexual, identidad o expresión de género, origen nacional, discapacidad o estado de veterano.Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.
Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.
Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly.
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