Remote Oncology Nurse Navigator & Care Coordinator

ANA-Ohio; Rocky Mount, Northern (NC, KY); Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Remote work

Benefits package

Job summary

CVS Health is seeking an Oncology Nurse Consultant (RN) for a 100% remote role spanning the contiguous U.S. You will lead clinical care coordination and utilization management within the Oncology Care Model, guiding members through diagnosis, treatment and recovery with a focus on evidence-based, cost-efficient care.

Join a multidisciplinary team and leverage NCCN guidelines to support treatment decisions while ensuring high-quality outcomes and member satisfaction throughout the cancer journey.

Qualifications

• Active, unrestricted RN license in state of residence.
• Ability to obtain multi-state licensure upon hire.
• Current ONCC certification (OCN, CPHON, CBCN, TCTCN, AOCNP, ROCN, AOCNS, AOCN).
• 5+ years of oncology nursing experience.
• 2+ years of Utilization Management experience.
• Knowledge of oncology treatment protocols, cancer symptom management, supportive care, evidence-based guidelines, medical necessity criteria.
• Experience collaborating with multidisciplinary healthcare teams.
• Excellent clinical judgment, critical thinking, and communication skills.

Responsibilities

• Clinical Case Management: conduct comprehensive assessments and develop/monitor care plans; assess needs across the cancer journey; advocate for benefits and services; support transitions of care and discharge planning; elevate quality-of-care concerns.
• Oncology Care Coordination: serve as a trusted resource; coordinate care with oncologists and providers; assess health literacy and readiness; provide education and coaching; support adherence.
• Utilization Management: perform reviews and evaluate medical necessity; apply NCCN guidelines to support treatment decisions; review exceptions with Medical Directors; review records for appropriate resource use; support cost-effective treatment.
• Collaboration & Program Development: participate in multidisciplinary oncology discussions; consult with providers and stakeholders; contribute ideas to improve program effectiveness and member experience; support goals around quality and resource optimization.

Skills

RN license

Oncology nursing

ONCC certification

Utilization Management

Multidisciplinary collaboration

Clinical judgment

Communication

Multi-state licensure

Oncology protocols

Education

Associate Degree in Nursing

BSN preferred

Job description

CVS Health is seeking an Oncology Nurse Consultant (RN) for a 100% remote role spanning the contiguous U.S. You will lead clinical care coordination and utilization management within the Oncology Care Model, guiding members through diagnosis, treatment and recovery with a focus on evidence-based, cost-efficient care.

Join a multidisciplinary team and leverage NCCN guidelines to support treatment decisions while ensuring high-quality outcomes and member satisfaction throughout the cancer journey.