Primary Nurse CA Specialty - Oncology Certification Required (ERS)
Richardson Texas HQ (1001 E. Lookout Drive)
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Job SummaryThis 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) Compact License 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 certification) 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/CDE/CDCDS 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 of 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:
Oncology Certification required
Registered Nurse Compact License
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
Current CCM certification
Knowledge of medical management policies and procedures
1-year education experience in Specialty area
This position is REMOTE / TELECOMMUTE
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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.
Base Pay Range$67,500.00 - $143,100.00 ApplyJob Profile
Multi-state license required
Benefits/PerksCareer growth Curated development plans Employee Referral Process Inclusive workplace Multi-state license fees covered Professional development Purpose-driven company
Tasks- Assist members
- Care coordination
- Case management
- Coordinate care
- Educate members
- Evaluate treatment options
- Manage oncology cases
- Perform case management functions
- Problem solving
Analytical Business Care Coordination Care management Case Management Clinical Care Clinical Experience Clinical Judgment Clinical Practice CM Communication Coordination of care Database Database experience Excel Goal setting Health care Health Insurance Healthy coping Insurance Lotus Notes Managed Care Management Medical Management Policies Nursing Oncology PC PC Proficiency Problem-solving Registered Nurse RN UM Word Written communication
Experience4 years
EducationBusiness Nursing Registered Nurse RN
CertificationsCCM CCM certification CDE Oncology certification Registered Nurse Registered Nurse License RN compact license
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9