This position is responsible for the assessment, care planning, and coordination of services for health plan members undergoing chemotherapy treatment. Services provided include ongoing monitoring of an appropriate and effective patient-centered care plan, member and family education regarding disease process, treatments and advanced care planning as well as providing evolving symptom management support throughout the member’s course of treatment. As part of care management, this role regularly communicates with the member's oncology provider and staff, and integrates the member, the family and the caregiver’s feedback into the assessment and care planning process.
- Serves as the primary nursing point of member and/or family contact. Assesses member/family needs including gaps in knowledge, manages care and services, and ensures effective communication among members, caregivers, providers and community supports.
- Provides navigation services to members throughout the cancer treatment process.
- Provides education in understandable terms regarding the disease and various treatment modalities.
- Identifies and prioritizes the member's needs and preferences. Develops quantifiable goals and desired outcomes, and promotes the member's ability to self-manage to the greatest extent possible.
- Utilizes motivation improvement techniques to empower members to actively participate in defining personal goals for their treatment plan and the ability to effectively communicate those goals to their provider.
- Provides care coordination that reduces unnecessary and unplanned hospitalizations or ER visits.
- Assesses member’s potential benefit from palliative care or hospice services as appropriate.
- Manages caseloads with continuous monitoring of reassessment needs and facilitates transitions of care when appropriate.
- Maintains timely, complete and accurate documentation in compliance with company policies and procedures as well as all regulatory, accreditation and client contractual obligations.
- Other duties as assigned.
Associates: Nursing (Required),Bachelors: Nursing
License and Certifications - Required
RN -Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - Preferred
OCN - OncologyNurse Certification - Care Mgmt,RNC -Registered NurseCertified (Area Of Specialty) - Care Mgmt
Other Job Requirements
Minimum 3+ years of clinical experience with focus on oncology.
Prior direct patient care in field of oncology required.
Telephonic medical case management experience.
Experience in utilization review of chemotherapy or specialty medications.
Familiar with clinical needs, chemotherapy regimens and disease processes for oncology patients.
Understands and adapts appropriately to issues related to communication, cognitive or other barriers.
Strong organizational skills and the ability to prioritize and follow through on multiple projects in a timely manner.
Strong documentation skills and ability to work well within an interdisciplinary team environment.
Strong verbal and written communication skills.