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Nurse Care Coordinator

2 weeks ago


Tulsa, Oklahoma, United States Health Care Service Corporation Full time

Job Summary:

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This position plays a crucial role in the management of members with specialty diagnoses, focusing on oncology. The successful candidate will perform all functions of case management and serve as a primary source of contact for members, healthcare personnel, and other entities involved in managing specialty care.

The ideal candidate will have strong clinical expertise, excellent communication skills, and the ability to work effectively in a fast-paced environment. They will be responsible for providing care coordination, consulting with physicians and providers, and promoting quality and cost-effective outcomes.

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Responsibilities:

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  • Perform all functions of case management, including assessing members for case management and facilitating the coordination of care">
  • Provide care coordination, consultation, and education to members, healthcare personnel, and other entities involved in managing specialty care">
  • Promote quality and cost-effective outcomes through effective care planning and coordination">
  • Collaborate with interdisciplinary teams to ensure seamless care transitions and optimal patient outcomes">
  • Develop and implement customized care plans that meet the unique needs of each member">
  • Monitor and report on key performance indicators, including adherence to treatment plans and improvement in health outcomes">
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Requirements:

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  • Registered Nurse (RN) with current, valid, unrestricted license in the state of operations">
  • 4 years of clinical practice experience, including 3 years of recent Specialty (oncology)">
  • Knowledge of specialty diagnosis drugs, adjunct therapies, and treatment protocols, including side effects and complications">
  • PC proficiency, including Word, Excel, Lotus Notes, and database experience">
  • Knowledge of UM/CM/DM activities and standardized criteria set">
  • Familiarity with ancillary services, including HHC, SNF, Hospice, etc.">
  • ONCOLOGY CERTIFICATION REQUIRED">
  • Experience in managing complex or catastrophic health cases">
  • 1-year experience in Care Management in a health insurance/managed care setting">
  • Knowledge of medical management policies and procedures">
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Preferred Qualifications:

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  • Certification in Oncology Nursing">
  • Experience working in a managed care environment">
  • Strong analytical and problem-solving skills">
  • Excellent communication and interpersonal skills">
  • Ability to work effectively in a fast-paced environment">
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What We Offer:

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We offer a competitive salary and benefits package, including health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, and other incentives.