Case Manager, Registered Nurse – Oncology Experience Required

Job Description:

• working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients
• application and/or interpretation of applicable criteria and clinical guidelines
• assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality
• consulting with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives
• utilizing motivational interviewing skills to ensure maximum member engagement
• identifying and escalating member’s needs appropriately

Requirements:

• 5+ years’ experience as a Registered Nurse, including at least 1 year in a hospital setting
• A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC)
• 1+ years’ experience documenting electronically using a keyboard
• 1+ years’ current or previous experience in Oncology
• 1+ years’ Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience preferred
• 1+ years' experience in Utilization Review
• CCM and/or other URAC recognized accreditation preferred
• 1+ years’ experience with MCG, NCCN and/or Lexicomp preferred
• Bilingual in Spanish preferred

Benefits:

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources based on eligibility