Case Manager, Registered Nurse – Oncology Experience Required
Job Description:
- Work 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 while assessing benefits and/or member’s needs
- Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers
- Consult with supervisors and multidisciplinary teams to benefit overall claim management
- Utilize motivational interviewing skills to maximize member engagement
- Identify and escalate member’s needs appropriately following set guidelines and protocols
- Perform medical necessity reviews
Requirements:
- 5+ years’ experience as a Registered Nurse, including at least 1 year in a hospital setting
- Active multistate license through the Nurse Licensure Compact (NLC) if residing in a compact state
- 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 preferred
- 1+ years’ experience with MCG, NCCN and/or Lexicomp preferred
- Bilingual in Spanish preferred
- Bachelor’s Degree or Associates Degree in Nursing required
Benefits:
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
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