Oncology RN Case Manager II

Job Description

We are seeking an experienced Oncology RN Case Manager II to provide comprehensive case management services for oncology patients and their families or caregivers. This role involves assessing patient needs, participating in care planning and intervention implementation, and ensuring thorough follow-up and coordination of healthcare services. The Case Manager II will also engage in community outreach initiatives and support administrative functions as needed.

All nursing practice will adhere to the legal scope of practice, national nursing standards, specialty guidelines, and applicable laws and regulations. Registered nurses in this role are accountable for maintaining professional standards and fostering strong community health relationships focused on patient well-being.

Earnings

N/A

Duties

• Participate in shared leadership and continuous professional development. Utilize evidence-based best practices to deliver high-quality nursing care. Engage in performance improvement initiatives at unit and department levels.
• Communicate patient care changes, denials, or high-risk situations effectively to reduce financial risk for patients and the organization. Navigate payer systems to secure coverage and connect patients to essential services.
• Collaborate with interdisciplinary teams to establish discharge criteria and streamline care transitions. Conduct thorough assessments to identify potential discharge barriers and patient needs. Develop and execute individualized care plans, including referrals to community resources and external providers.
• Ensure accurate documentation according to policy and regulatory requirements. Perform clinical reviews and validate third-party payer authorizations or denials.
• Identify opportunities to enhance customer service, reimbursement processes, and overall organizational performance. Contribute to problem-solving efforts and promote team development.
• Foster respectful and collaborative relationships within the healthcare team. Be receptive to diverse ideas and work jointly toward shared goals.
• Promote a culture of safety by addressing unsafe behaviors and validating critical information for clinical decisions. Maintain clear, accurate communication to support patient and staff safety.
• Utilize resources efficiently and seek cost-effective methods without compromising quality of care.

Requirements

• Minimum of 5 years nursing experience, with at least 3 years in a pediatric setting (Required)

License / Certification

• Master’s Degree in a related field (Required
• Registered Nurse licensure (Required
• Management certification (Preferred)