RN, Registered Nurse -Oncology Pre-Certification

Quantum Health; Dublin (OH); Hybrid; USD 70,000 - 85,000; Full time

Job summary

A healthcare service provider in Dublin, OH is seeking a Registered Nurse for Oncology Pre-Certification. The role involves reviewing oncology service requests, working with clinicians, and coordinating patient care. Ideal candidates should have a nursing degree, oncology experience, and excellent communication skills. This position offers hybrid flexibility.

Qualifications

• Minimum of 2 years of oncology nursing experience.
• Strong working knowledge of NCCN guidelines.
• Trustworthy and accountable behavior.

Responsibilities

• Review and process all requests for oncology services.
• Communicate with members and providers regarding request outcomes.
• Identify care coordination opportunities.

Skills

Oncology nursing experience

Critical thinking

Interpersonal skills

Communication skills

Administrative/technical skills

Education

Bachelor’s degree in nursing or closely related field

Active RN license in Ohio

Tools

Microsoft Office

IM/video conferencing tools

Job description

RN, Registered Nurse - Oncology Pre-Certification

Location: Dublin, OH campus with hybrid flexibility.

Overview

The Pre-Certification Nurse, Oncology is responsible for reviewing oncology service requests related to clinical trials, chemotherapy and radiation therapy for enrollees of Quantum Health’s employer groups. This position will work to increase the consistency and efficiency of oncology service requests.

Responsibilities

• Review and process all requests for oncology services related to clinical trials, chemotherapy and radiation.
• Work with Medical Director/Physician reviewer for all requests requiring physician review.
• Communicate with members, providers, facilities, and all internal work groups regarding the outcome of requests.
• Maintain a working knowledge of all clinical processes and workflows, as well as all employer benefit plans and how to access needed information.
• May serve as a Subject Matter Expert (SME) for a clinical process or content area; may participate in educational training with clinical staff regarding oncology nursing services.
• Identification of members who may be appropriate for case management services (Complex, High cost, Transplant).
• Identify care coordination opportunities and work with clinical teams to coordinate oncology services.
• All other duties as assigned.

Qualifications

• Bachelor’s degree in nursing or closely related field or equivalent experience
• Minimum of 2 years of oncology nursing experience
• Active license as a Registered Nurse in the state of Ohio
• Strong working knowledge of NCCN (National Cancer Comprehensive Network) guidelines
• Excellent critical thinking skills
• Strong interpersonal skills
• Excellent verbal and written communication skills
• Self-directed, organized with excellent time management skills
• Protect and take care of our company and member’s data every day by committing to work within our company ethics and policies.
• Strong administrative/technical skills;Comfortable working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
• Trustworthy and accountable behavior, capable of viewing and maintaining confidential information daily.