RN – Oncology Nurse Care Manager

RN – Oncology Nurse Care Manager

Requirements

• Active unrestricted Registered Nurse (RN) license in Georgia
• At least 3 or more years of full-time direct patient care as an RN
• At least 1 or more years Oncology experience is required
• Ability to obtain URAC-recognized certification in Case Management within four (4) years of hire
• Excellent communication skills including telephonic (verbal) and digital (messaging, emails)
• Skilled in clinical acumen to form a judgement and act
• Strong computer skills in Microsoft word, Excel, Outlook, and ability to perform thorough internet research
• Ability to recognize, address and resolve conflicts in a professional, collaborative manner
• Demonstrates sensitivity to culturally diverse situations, participants, and customers
• Demonstrates effective organizational skills and flexibility to meet the business needs
• Adapts approach and demeanor in real time to match the shifting demands of different situations
• Ability to manage multiple, complex situations in a fast-paced environment collaborating with clinical and other business partners

Responsibilities

• Collaborates with customer in creation of care plan and documents plan in medical management system
• Partners with each customer to establish goals and plan interventions to meet the customer’s needs
• Establishes plan of care in conjunction with the customer and provider, then document into medical management system
• Utilizes motivational interviewing, behavior change, and shared decision making to help customers achieve optimal health and well-being
• Empowers customers with skills to enhance interaction with their providers
• Interfaces with the customer, family members/caregivers, providers, and internal partners to coordinate the needs of the customer through telephonic, email, text, and chat interactions
• Collaborates with nutritionist, pharmacist, behavioral clinician, Medical Director and customer’s provider and other Cigna Medical Management programs to provide whole-person health support
• Identifies gaps in care and works with customer, providers, and/or local community resources to close gaps in care
• Provides steerage and referrals to high quality in-network providers
• Acts as a primary liaison for the customer, partnering with internal programs, external programs, and all matrix partners to support positive outcomes
• Identifies and builds effective relationships with local in-network providers
• Tracks daily activities to trend volume and outcomes
• Follows standard operating procedures
• Toggles between multiple systems and applications
• Research relevant topics in health promotion and disease prevention, as required for specific customers
• Prioritizes work to meet commitments aligned with organizational goals
• Understands and adheres to Case Management performance measures to deliver on key results
• Completes training within the communicated time limit as required per role
• Demonstrates evidence of continuing education to maintain clinical expertise, licensure, and certification as appropriate

Preferred Qualifications

No preferred qualifications provided.