Clinical Support & Case Review Nurse | Per Diem | NantHealth

The Clinical Support and Case Review Nurse is a key member of both the Medical Operations and Client Support teams. In this role, you'll successfully ensure that all clinical and plan information is collected and thoroughly reviewed in order to present a full clinical picture including diagnosis, stage, pathology and proposed treatment plan for medical office review for cases that do not receive an automated code via the Eviti platform.

As a Clinical Support and Case Review Nurse, you will interact with physicians’ offices and their clinical staff to resolve Eviti reported clinical incidents/questions and perform clinical analysis on those incidents in conjunction with the Eviti Support team. As an initial reviewer, you'll never issue a non-certification decision; the physician will be responsible for issuing non-certification determinations. A successful candidate for this position must be an experienced oncology nurse familiar with evidenced based treatment protocols for a wide variety of cancers. You are results-driven, organized, effective at communicating, have excellent troubleshooting skills, and be able to prioritize tasks while working on multiple clinical issues.

Responsibilities include, but are not limited to:

• Review case information in Eviti Customized treatment cases and compare against the submitted diagnosis field and treatment field to validate that the information accurately depicts status of patient and planned treatment
• Contact physicians’ offices and obtain all necessary information from medical records
• Follow-up with the submitting office to clarify any inconsistencies between the provided notes and the submitted diagnosis field and treatment plan
• Request additional clinical information at the direction of the Oncology Certified NP or MD
• Monitor progress of report and intervene to ensure timely delivery of product as agreed upon by client
• Act as a clinical resource for all non-clinical staff to address clinical questions or concerns
• Respond to customers and support team following a defined support process
• Identify, research, and resolve customer clinical issues
• Present a professional image at all times to customers and vendors
• Work collaboratively with other service delivery areas to provide clients with a superior experience and ensure commitments made to the client are handled appropriately
• Ability to work flexible hours providing support coverage

Education & Experience Requirements:

• Current Active Unrestricted Registered Nursing License in a state or territory of the United States
• BSN in Nursing
• 5 Years Oncology Experience, OCN certification 
• Demonstrated strong attention to detail and documentation
• Strong computer skills and ability to communicate professionally in writing

Knowledge, Skills, and Abilities:

• Strong knowledge of oncology and insurance industry
• Excellent interpersonal skills, with ability to relate to patients, medical management personnel, office practice and hospital staff
• Ability to utilize critical thinking skills in order to address clinical needs of oncology patients
• Ability to strictly adhere to aggressive timelines
• Proven ability to problem solve and take initiative without needing supervision in a fast-paced environment
• Experience with Microsoft Office Products
• Strong customer services orientation

The anticipated hourly rate for applicable US-based applicants to this position is below.