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Care Coordinator RN

2 months ago


Nashville, United States Tennessee Oncology Full time

Tennessee Oncology, one of the nation's largest, community-based cancer care specialists, is home to one of the leading clinical trial networks in the country. Established 1976 in Nashville, Tennessee Oncology's mission remains unchanged: To provide access to high-quality cancer care and the expertise of clinical research for all patients, at convenient locations within their community and close to their home. Our growing network of physicians and locations is based on this mission. Tennessee Oncology is committed to advancing both the science of detection and targeted treatments, and to making these advances available to every patient. We believe caring for cancer patients is a privilege.

Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

Job Description:

The Care Coordinator is an experienced nurse who demonstrates critical thinking and uses the nursing process to assess and meet the needs of oncology patients and caregivers throughout the care continuum for Tennessee Oncology (TO). S/he will monitor the patient's status and treatment plan and communicate with the patient, provider and healthcare team from the time of decision to treat through transition to survivorship follow up or end of life care when appropriate to ensure effective, timely and appropriate needed delivery of care and services. The fundamental goals of care coordination are to minimize unplanned hospitalizations and ED visits, optimize patient centered processes that promote patient satisfaction, assure ease of access to palliative/ supportive care services and focus on the enhancement of the overall health of the patient considering comorbidities, diagnosis, and disease related distress

ESSENTIAL FUNCTIONS:

  • Coordinates timely scheduling of appointments, diagnostic testing, procedures, education, and treatment schedules to expedite the plan of care for the patient
  • Ensures that essential medical records are available at scheduled appointments
  • Maintains regular contact with patients, caregivers and healthcare providers to assess health status and satisfaction with cancer care experience
  • Tracks patient progress along care continuum, identify and collaborates with the care providers to remove potential or actual bottlenecks, gaps or barriers to progress
  • Works with providers to determine optimal methods for communicating to patient test results/treatment progress recommendations
  • Helps explain disease processes and treatment recommendations, risks and benefits, in conjunction with direct care providers, and answers questions. Reinforces education provided at the clinics about tests, procedures, medications, etc
  • Reviews smoking status, distress, and clinical depression screening results and collaborates with clinic staff to implement appropriate interventions
  • Educates patient and or facilitates referrals about diet, exercise, smoking cessation, and other wellness strategies
  • Provides symptom management education/counseling.
  • Connects with patient before and or after treatment, major testing, inpatient hospitalization and or ED visit. Connects after missed appointments to check on status, needs, and understanding of care plan
  • Builds relationships and collaborates with local / regional individuals, agencies, and organizations to facilitate access to community-based cancer care services
  • Ensures referrals to ancillary services and or other healthcare providers are made in a timely manner including monitoring patient follow through with scheduled referrals/appointments
  • Facilitates referrals to language translators/interpretation services, patient advocate, social worker, financial counselor, chaplain, mental health services and or other resources and ensures follow through with appointments and or recommendations
  • Facilitates completion of care related forms by clinic staff (FMLA, disability, etc.)
  • Facilitates access to clinical trial information/resources
  • Educates patient about survivorship, reinforces expectations related to post treatment transition and remains available to the patient in the event of disease relapse or a secondary malignancy
  • Facilitates a smooth transition of patients to end-of-life care
  • Evaluates outcomes of care by measuring intervention effectiveness, data gathering and continued evaluation for needed improvements
  • Prepares and submits, on time, reports related to care coordination performance and care metrics
  • Participates in community cancer screening, education, supportive events
  • Participates in process improvement activities to optimize patient centered care
  • Travels to and meets with assigned clinic providers and staff on a regular basis to build a rapport with healthcare team and assure essential functions of care coordination are being met
  • Promotes program to patients, providers and community in a positive manner
KNOWLEDGE, SKILLS & ABILITIES:
  • Strong written and verbal communication skills
  • Strong time management skills
  • Ability to work independently with minimal direct supervision
  • Ability to use computer for documentation, create and run reports and tracking patient progress and care metrics
  • Ability to demonstrate and promote teamwork
  • Ability to work remotely yet build rapport with patients, families and care providers
  • Ability to proactively and diplomatically problem solve
  • Ability to effectively delegate and follow through on task completion
EDUCATION & EXPERIENCE:
  • Registered Nurse with current RN state license.
  • Minimum of 1 year in oncology nursing experience or relevant care coordination experience
  • Certification in Oncology Nursing is required within 15 months of hire.
  • Current ONS Chemotherapy/Biotherapy Card is required within 6 months of hire.
  • AHA/ARC BLS certification required within 90 days of hire if employee works greater than 80% of shifts on-site/in-clinic. BLS certification is optional for teams working primarily remote.
PHYSICAL REQUIREMENTS:
  • Must be willing and able to lift up to 50 pounds.
  • Must be willing and able to travel to assigned TO clinics