Oncology Case Manager RN

Oncology Case Manager RN

Requirements

• A Registered Nurse that must hold an unrestricted license in their state of residence, with multi-state/compact privileges and be willing and able to be licensed in all non-compact states
• Upon hire, it will be required to obtain all 50 state licenses
• 2+ years of clinical practice experience required as an RN working specifically with oncology patients
• There is a requirement to live within a commutable distance of Phoenix, Arizona (typically within 45 minutes maximum)

Responsibilities

• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration
• Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues
• Assessments consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality
• Reviews prior claims to address potential impact on current case management and eligibility
• Assessments include the member’s level of work capacity and related restrictions/limitations
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management
• Utilizes case management processes in compliance with regulatory and company policies and procedures
• Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Preferred Qualifications

• One of the following types of oncology RN certifications through the Oncology Nursing Certification Corporation (ONCC): Oncology Certified Nurse (OCN), Certified Pediatric Hematology Oncology Nurse (CPHON), Certified Breast Care Nurse (CBCN) or Blood & Marrow Transplant Certified Nurse (BMTCN)
• Certified Case Manager (CCM) certification
• Case Management in an integrated model