Clinical Case Specialist

About the role

Solventum, formerly 3M Health Care, is looking for a Clinical Case Specialist to provide specialized professional and technical support to its customers, distributors and sales teams. The role builds expertise in assigned products and projects while learning about the business, organization and customer base. It is a hybrid position; relocation assistance is not available.

Key responsibilities

• Assist with urgent patient placement orders and determine patient qualifications for medical necessity based on payor coverage criteria.
• Resolve clinical issues related to the billing process and interpret clinical documentation to identify the correct diagnosis codes.
• Interface with internal and external departments so that Solventum's clinical guidelines guide decisions.
• Evaluate and recommend on VAC placements that are not showing wound healing or improvement.
• Evaluate and generate payer appeals for adverse determinations by commercial payers (MCO).
• Analyze medical necessity cases to advise on trends and patterns, and validate medical necessity for all payor types.
• Act as a resource for nonclinical staff, conduct training as needed, and build relationships with customers, KOLs, professional associations, universities and regulatory stakeholders.
• Train internal and external stakeholders and sales teams on clinical or technical standards, and support localization of product documentation and training materials.
• Communicate concerns and escalate issues as appropriate.

Required profile

• High school diploma.
• Advanced English (B2).
• Bachelor's degree or higher in sales, marketing, clinical or medical sciences, training, technical life sciences or a related field.
• Up to one year of relevant experience in nursing or a clinical office setting, with a solid understanding of anatomy and physiology and medical terminology.
• Basic knowledge of theories and practices in at least one relevant discipline.
• Legal authorization to work in the country of employment without a visa sponsorship.

Required skills

• Working knowledge of computer programs relevant to the assigned area.
• Additional value: clinical education or experience, experience supporting customers, distributors or sales teams, basic analytical skills, and clear communication of technical or clinical information.