Remote in Florida Oncology Nurse Navigator WellMed

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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

The Oncology Nurse Navigator (ONN) enhances navigation through the complexity of cancer care for patients and providers as a dedicated patient-care facilitator with clinical responsibilities integrated as a member of the care team. Function is responsible for enhancing communication between and among Oncology patients enrolled in the Oncology program, their caregivers and providers. The ONN will coordinate, or provide appropriate levels of care, under the direct supervision of an Registered Nurse (RN) Manager or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for patients. The ONN will act as an advocate for patients and their families to guide them through the health care system. The ONN will work in partnership with an assigned Care Advocate and Social Worker. This position will be under the general guidance of the Manager of Care Management with a dotted line to the WellMed Oncology Medical Director (Oncology Program Lead).

Primary Responsibilities:
  • Engage patient, family, and caregivers telephonically to assure that a well-coordinated action plan is established and continually assess health status
  • Independently serves as the clinical liaison with hospital, clinical and administrative staff
  • Provide member education to assist with self-management goals; disease management or acute condition and provide indicated contingency plan
  • Identify patient needs, close health care gaps, develop action plan and prioritize goals
  • Utilizing evidenced-based practice, develop interventions while considering member barriers independently
  • Utilize motivational interviewing techniques to understand cause and effect, gather or review health history for clinical symptoms, and determine health literacy
  • Manages assessments regarding patient treatment plans and establish collaborative relationships with physician advisors, clients, patients, and providers
  • Utilize multiple EMR platforms to reconcile information (ie TruCare, eCW and ePRG)
  • In partnership with care team triad, make referrals to community sources and programs identified for patients (ie Palliative or Hospice etc)
  • Demonstrate knowledge of utilization management processes and current standards of care as a foundation for utilization review and transition planning activities
  • Monitor patient compliance with patient treatment plan
  • Collaborates effectively with Interdisciplinary Care Team (IDCT) to establish an individualized action plan for patients
  • Independently confers with UM Medical Directors and/ or Market Medical Directors on a regular basis regarding oncology cases and participates in departmental huddles
  • Maintain in-depth knowledge of all company products and services as well as customer issues and needs through ongoing training and self-directed research
  • Manage assigned caseload in an efficient and effective manner utilizing time management skills
  • Enters timely and accurate documentation into designated care management applications to comply with documentation requirements and achieve audit scores of 95% or better on a monthly basis
  • Maintain current licensure to work in state of employment and maintain hospital credentialing as indicated
  • Coordinate with Oncology Program lead to identify issues affecting quality, readmissions, leakage, and increased length of stay while working to identify processes to improve
  • Designs or participates in the creation of any oncology health education materials
  • Monitors and tracks Oncology program metrics for outcomes. Prepare month report of patient enrollment and interventions
  • May participate in the orientation, training and evaluation of new staff
  • Performs all other related duties as assigned

Only candidates living in Forida will be considered to travel within the Florida market areas.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
  • Associate's degree in Nursing
  • Oncology Nurse Certification (OCN) required within one year of hire
  • Nurse Navigation Certification required within three years of hire
  • Current, unrestricted RN license required, specific to the state of employment
  • Experience administering chemotherapy or other specialty infusion treatments
  • 2+ years of managed care and/or case management experience with an additional one year of Oncology Nursing experience
  • Ability to plan, implement and evaluate individual patient care programs
  • Knowledge of related accreditation and certification requirements
  • Ability to gather data, compile information, and prepare reports
  • Basic knowledge of Microsoft Office products, including Word, Excel and Outlook
  • Work independently, with some supervision and direction from manager
  • Possess and demonstrate organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers
  • Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
  • Maintain strict confidentiality at all times to include but limited to patients and coworkers
  • Comply with all organizational policies regarding ethical business practices
  • This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease.
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:
  • 2+ years of Oncology Nurse experience in a physician's clinic or hospital
  • Bilingual language proficiency (English / Spanish)

Physical & Mental Requirements:
  • Ability to lift up to 25 pounds
  • Ability to push or pull heavy objects using up to 25 pounds of force
  • Ability to sit for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving

If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Job Keywords: Oncology Nurse Navigator, RN, Registered Nurse, Managed Care, Case Management, Tampa, FL, Florida

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