Clinical Specialist (New Health Care Company)

Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers’ toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Description:

Clinical Case Specialist

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(n) 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:

• Performing initial and subsequent clinical reviews to validate medical necessity and patient eligibility based on payer-specific coverage criteria across all payer types.
• Serving as a liaison between patients, prescribers, internal teams, and payer sources to resolve clinical issues related to the order-to-cash revenue cycle.
• Supporting complex cases, including wound therapy (e.g., negative pressure wound therapy) by reviewing clinical documentation, assisting with diagnosis coding, and evaluating cases that are not demonstrating expected progress.
• Developing, drafting, and/or supporting clinical appeals for adverse determinations, and identifying trends or patterns in medical necessity reviews to inform process improvements.
• Acting as a clinical resource for non-clinical staff by providing education, conducting training, and promoting Solventum therapies through explanation of product features, benefits, and appropriate use.

Your Skills and Expertise

To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications:

• High School Diploma/GED or higher (completed and verified prior to start) from an accredited institution

AND

• Licensed clinician with LPN/LVN certification or higher (completed and verified prior to start) from an accredited institution

Additional qualifications that could help you succeed even further in this role include:

• Two (2) years of experience working in a government or private payer organization
• Experience working in a Utilization Management position
• Knowledge of regulatory requirements across different payer types (e.g., commercial, government, managed care)
• Knowledge and/or experience in quality assurance or quality improvement initiatives
• Experience and/or clinical knowledge in wound care

Additional Requirements

In this role, you may interact with healthcare providers, payers, and other external stakeholders. Those organizations may, in turn, require you to possess certain credentials or complete specific verifications for regulatory, safety, or other business reasons. All information will be kept in accordance with applicable law and Solventum policies.

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.

Applicable to US Applicants Only:The expected compensation range for this position is $72,681 - $88,832, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-Rewards

Responsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.

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.

Solventum is an equal opportunity employer.  Solventum  will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.

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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