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Join a purpose-driven organization that values employee development and offers a rewarding career in case management. This role focuses on managing members with specialty oncology diagnoses, providing care coordination, education, and support to enhance health outcomes. As a primary contact for members and healthcare personnel, you will play a crucial role in evaluating treatment options and facilitating access to necessary resources. With a commitment to fostering an inclusive workplace, this innovative company is dedicated to empowering its employees and ensuring their professional growth. If you are a compassionate RN with oncology experience, this remote position could be your next career milestone.
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This position’s primary focus is the management of members with specialty (oncology) diagnoses. This position will be responsible for performing all functions of case management (CM) and is a primary source of contact for members, health care personnel, and all other entities involved in managing specialty care. The primary nurse case administrator performs care coordination; identifies alternate treatment programs; consults with physicians, providers, members, and other resources to evaluate options and services required to meet an individual’s health needs; promotes quality and cost-effective outcomes; and serves as liaison to physicians and members. Provide education/local resource information and encourage member (self) education functioning in a clinical care advisory role. The primary nurse case administrator assesses members for case management, introduces members to our website tools, educates members regarding their specific condition, and facilitates the coordination of care for identified members.
JOB REQUIREMENTS:
Registered Nurse (RN) with current, valid, unrestricted license in state of operations
4 years clinical practice experience of direct clinical care, to include 3 years of recent Specialty (oncology) clinical experience
Knowledge of specialty diagnosis drugs, adjunct therapies, and treatment protocols including side effects and complications
Current certification in one of the following: ONS/ONCC/AOCN/CPON/AOCNP
PC proficiency to include Word, Excel, Lotus Notes, and database experience
Clear and concise verbal and written communication skills
Knowledge of UM/CM/DM activities and standardized criteria set
Familiarity with ancillary services including HHC, SNF, Hospice, etc.
Verbal and written communication skills; analytical skills; sound clinical judgment
Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC.
Knowledge of drugs and treatment protocols including side effects and complications
Knowledge of diets relating to assist members
Knowledge of Problem Solving, Healthy Coping, and establishing SMART goals.
Current Certified Specialists must maintain their certification.
PREFERRED JOB REQUIREMENTS:
RN Compact License required
ONCOLOGY CERTIFICATION REQUIRED
CCM certification
Experience in managing complex or catastrophic health cases
Inpatient and Outpatient experience preferred.
1-year experience in Care Management in a health insurance/managed care setting
Knowledge of medical management policies and procedures
1-year education experience in Specialty area
This position is Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.
Compensation: $69,200.00 - $146,700.00
Exact compensation may vary based on skills, experience, and location.
HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.