Nurse Case Manager - Oncology Expert

  • Full-time

Company Description

INTERLINK Health Services was founded in 1995 and is headquartered in Hillsboro, Oregon. INTERLINK is well known as the leader in outcome-based managed care, providing access to the nation’s finest centers for cancer, bone marrow, and solid organ transplant services. INTERLINK is a stable and growing company, focused on the delivery and continued development of outcome-based cost containment products to meet the expanding healthcare market. The CancerCARE Program is INTERLINK’s most desired program and is projected to grow rapidly over the next 2-3 years. Additionally, new program launches are occurring that will be market leading in nature.

Job Description

CancerCARE has a satellite office in Omaha (the Millard area) and is seeking a full-time RN with extensive experience working in the managed care industry.  Oncology experience in the managed care industry is preferred.  You will have extensive support provided by both Medical Directors and other Oncology Nurse Experts.  If you live within driving distance of this office, we would love to hear from you.  (This is NOT a work from home position).

As an Oncology Nurse Expert, you will be working telephonically with Members diagnosed with high-risk or metastatic cancer.  You will review NCCN guidelines and work collaboratively with both the Member and their providers to ensure evidence-based care is being given.  If a case warrants it, you will coordinate either onsite or remote access to a Center of Excellence (COE) facility.

The CancerCARE program is considered the next-generation style of cancer management which involves specially drafted benefit language, extensive use of NCCN Guidelines® and custom-built COE networks. This position comes with an opportunity for professional growth.

Essential Responsibilities/Accountabilities
 

  • Conduct comprehensive assessment of the Member’s health and psychological needs to develop a collaborative care plan with the Member and his/her medical team
  • Individualize Members’ care using a Member-centric, collaborative, comprehensive, and holistic approach to facilitate Member engagement and provide education and empower them to be an active participant in their treatment decisions
  • 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
  • Discuss COE access options with the Member as appropriate
  • Advocate for Members dependent on their needs
  • Documents all activities in electronic medical record (EMR)
  • Perform all duties efficiently while keeping cost containment and Member-centric quality care a priority
  • Prepares reports in a timely manner, per policy by collecting, analyzing, and summarizing activities and interventions along with treatments based on NCCN, CVP, and our COE networks.

Qualifications

  • Must commute to this West Omaha, NE office
  • Effective verbal and written communication required
  • Excellent organizational and time management skills required
  • Compassionate teamwork, experience in multi-tasking and working in groups
  • Experience in working with managed care, TPA, or medical stop-loss and reinsurance industry is ideal

Education and Experience:
 

  • RN with active license
  • Minimum of 3-5 years of case management experience within a Managed Care Setting (HHC, Hospice and Inpatient Case Management not considered)
  • Case Management Certification preferred (must be willing to sit for exam as soon as eligible)
  • Extensive Oncology Experience desired
  • Must have familiarity with reviewing medical records
  • Oncology Certification (OCN) preferred, but required to sit for exam as soon as eligible
  • Experience in or knowledge of insurance, TPA, or medical stop-loss and reinsurance industry preferred
  • Being Bi-lingual is not required, but is beneficial

Additional Information

Compensation commensurate with experience
 

Benefits:

Health benefits package, 401K plan, profit sharing, paid personal time off. Position is salaried and overtime ineligible. All necessary technologies will be provided.

Only qualified candidates will be contacted. For more information about CancerCARE by INTERLINK Health Services, please visit: https://cancercare.interlinkhealth.com/