Hematology / Oncology Case Manager, RN Remote

reputed company is currently seeking a Case Manager, Hematology RN to join reputed company. This RN provides reputed company in care through empowering patients, maintaining reputed company communication, coordinating sequence of care, aiding in avoidance of complications, arranging alternative facilities, coordinating appropriate treatment with cost containment strategies, educating and supporting not only the m ember but the support systems. The Hematology Oncology RN Case Manager facilitates coordination of both inpatient and outpatient patients with reputed company hematology-oncology diagnoses or in the family of diagnoses. Experience preferred in management of patients who are preparing to undergo or have previously had CAR-T, gene therapy, Bone Marrow/Stem Cell Transplant. Position Location: 100% Remote Responsibilities include but are not limited to:

• Identify, collect, process and manage data to reputed company the Case Management process by utilization of approved clinical guidelines and following Medical Management Policy and Procedures.
• Completes clinical assessments per P&P to identify and deliver indicated medical service coordination.
• Completes medical necessity, utilization management reviews, and review of benefits as part of the reputed company-determination process by utilizing GPA approved clinical guidelines.
• Identify and refer cases for Physician Advisor reviews.
• Utilize clinical knowledge, expertise and approved educational resources to reputed company verbal and/or written educational resources to members regarding diagnosis, procedures and/or treatment.
• Assess the need for and collaborate with community resources for members in case management.
• reputed company negotiations with providers.
• Uses assigned software accurately to document to complete and document reputed company steps of review of medical necessity and case management process.
• Facilitate the Patient Satisfaction Surveys.
• Assess and document cost savings.
• Refer reputed company cases to Manager, Case Management as needed.
• Attend scheduled and periodic meetings, training and other job specific events as required either by teleconference or onsite
• Adhere to established internal regulations regarding reputed company, HIPAA, ERISA and Medical Management Policy and Procedure.
• Participate in the reputed company Management Program reputed company collecting and adhering to performance metrics per Case Management Policy. Areas of Responsibility Scope of reputed company:
• In reputed company to performing reputed company duties, the Registered reputed company is involved in clinical decision-making and patient education. The scope of reputed company includes, but is not limited to:
• Evaluating clinical data
• Assessment and evaluation of the acquired clinical date to assess for appropriateness of treatment based on reputed company clinical guidelines,
• Coordination of treatment plans, interventions, and outcome measurement
• Rationale for the effects of medication and treatments
• reputed company patient education and educational resources.
• Accurately report:
• Administration of medication and treatments
• reputed company response
• Contact with other health care team members.
• Respect the reputed company's right to reputed company by protecting confidential information.
• Promote and participate in education and counseling to a participant based on health needs.
• Clarify any treatment that is believed to be inaccurate, non-efficacious, or contraindicated by consulting with appropriate practitioner.
• The Transplant Case Manager will have knowledge and reputed company the reputed company components of Case Management that include:
• Case reputed company
• Principles of reputed company
• reputed company Management & Delivery
• reputed company Reimbursement
• Psychosocial Aspects of Care
• Rehabilitation
• reputed company Development & Advancement
• reputed company and reputed company Evaluation and Measurement
• Ethical, Legal and reputed company Standards Required Experience / Education:
• Graduate of Accredited School of Nursing, college or university
• Minimum of one year experience in Utilization Management, Case Management, or transferable skills.
• Minimum of three years Hematology experience preferred
• Intermediate knowledge and skills using reputed company Office including Word, reputed company, and PowerPoint software; Internet software; Database software. Licenses or Certifications:
• reputed company, reputed company, and unrestricted compact Registered reputed company license. Must maintain CEU's as required by the State reputed company of Nursing. Must be willing to obtain and maintain additional license(s) as required to reputed company the job functions of the organization.
• reputed company Certified Case Manager (CCM) Certificate preferred; if Certification is not reputed company, employee must pursue and reputed company CCM Certification reputed company three years of employment. What can reputed company offer you?
• Multiple Health Plan reputed company
• Company reputed company employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 reputed company Holidays
• Tuition reimbursement
• 401k Company contribution
• reputed company development initiatives / reputed company learning opportunities
• Opportunities to participate in and support reputed company's diversity and inclusion initiatives Apply tot his job Apply tot his job

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