The Clinical Support Review Nurse is a key member of both the Medical Operations and Client Support teams. The purpose of this position is to successfully ensure that all clinical and plan information is collected and is 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. In addition, the Clinical Support Review Nurse will interact with physician's 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, the Clinical Support Review Nurse will never issue a non-certification decision.
The Clinical Review Support Nurse will have access to a qualified physician reviewer during standard operation hours to assist in initial clinical review. The physician will be responsible for issuing non-certification determinations. The Clinical Support Review Nurse must be an experienced oncology nurse familiar with evidenced based treatment protocols for a wide variety of cancers. The appropriate candidate will be results-driven, organized, effective at communicating, have excellent troubleshooting skills, and be able to assess prioritization while working on multiple clinical issues.
Position Locations: Culver City, CA, Philadelphia, PA or remote/work from home.
* 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 physician office 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 requiring expert clinical assistance in entering oncology plans of care into an automated system 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
What You Bring
* BSN in Nursing required * 5 Years Oncology Experience, OCN certification required * Demonstrated strong attention to detail and documentation * Strong computer skills and ability to communicate professionally in writing * 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
Required Certifications or License
* Current Active Unrestricted Registered Nursing License in a state or territory of the United States
What We Bring
* We offer competitive compensation, full benefits and some great perks. More importantly, we offer you the chance to work with a great team, focused on providing leading software-based solutions and services across a continuum of care. * Excellent benefits package including medical(HMO/PPO), dental, and vision, and a 401k with company matching so you can continue planning for financial wellness. * Flexible/Unlimited Style Paid Time Off with 11 Paid Holidays * Employee discounts on things like, mobile products and services, gym memberships, and a variety of additional entertainment options.
NantHealth, Inc. is a member of the NantWorks ecosystem of companies, is a next-generation, personalized healthcare company that enables more effective treatment decisions for critical illnesses and improved patient outcomes by empowering clinical decision support and providing leading software-based solutions and services across the continuum of care for physicians, payers, patients and biopharmaceutical organizations.
NantHealth is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, ancestry, national origin, sex, sexual orientation, age, disability, marital status, domestic partner status, or medical condition.This job description is intended to describe the general nature and level of work being performed by the person assigned to this position. The primary duties and responsibilities are intended to describe those functions that are essential to the performance of this job and does not state or imply that the above are the only duties and responsibilities assigned to this position.
Associated topics: advanced practice registered nurse, arnp, assessments, care nurse, certified nursing, certified nursing assistant, clinic, community, ob, spanish
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.