Primary Nurse CA Specialty-Oncology
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TELECOMMUTER ROLE FOR THE STATE OF TEXAS
This Position Primary Focus Is The Management Of Members With Specialty (Oncology / Diabetes) 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.
* 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 / diabetes) 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:
* 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
* Case Management experience is a plus
* MUST have current certification in one of the following: ONS/ONCC/AOCN/CPON/AOCNP/CDE/CDCDS
Relocation assistance will not be provided for this position.
Sponsorship will not be provided for this position.
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HCSC Employment Statement:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.