A Navigator Nurse is one whose clinical expertise and training can help guide patients to make informed decisions and provide supportive care throughout the cancer continuum to work in our Triage Center. The Navigator nurse will serve as an advocate for intermediate risk cancer patients and reach out to them on a regular basis, educating them and receiving updates on their current phase in their treatment plan. He/She will review NCCN guidelines and work collaboratively with both the Member and his/her providers to ensure evidence-based care is being provided. If a case warrants it, he/she will coordinate either onsite or remote access to a Center of Excellence (COE) facility. He/she will transition Members with complex cancer needs to an Oncology Nurse Expert to coordinate Member care.
Qualifications:
Essential Responsibilities/Accountabilities:
· Work cohesively with triage center Intake Coordinators and Oncology Nurse Experts
- Promote the use of evidence-based care through extensive use of NCCN Guidelines®, Clinical Trials.gov, McKesson Clear Value Plus, and the use of our COE networks
- Assess new patients’ need for treatment at a Center of Excellence Facility
- Document all activities in electronic medical record (EMR)
- Perform all duties efficiently while keeping cost containment and patient centric quality care a priority
- Effectively communicates the status of patient activities through the use of Notification Forms, email and/or telephone.
- Understands and makes decisions based upon benefit plan language.
Additional Responsibilities:
- Maintain integrity of company image, philosophy, and methods in all communications
- Represent CancerCARE and health plans by being professional at all times.
Job Qualifications (Knowledge, Skills and Abilities):
- RN with active license (Compact state license preferred)
- Excellent relationship-building skills
- Excellent verbal and written communication skills
- Exemplary computer and technical skills. Feel comfortable with learning new technology and troubleshooting technology
- Proficiently type directly into an electronic medical record while obtaining information telephonically from the patient
- Strong organizational skills with the ability to multi-task
- Proficient in Microsoft Office
- Strong analytical and problem-solving skills
- Self-motivated
- Able to work independently and in a team environment
Education and Experience:
- RN with active license; Compact State license and Oncology experience preferred
- Management experience desired
· Must have familiarity with reviewing medical records
· Experience in or knowledge of insurance, TPA, or medical stop-loss and reinsurance industry preferred
· Bi-lingual candidates preferred
Job Type: Full-time
Pay: $85,000.00 – $88,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
Work Location: Remote