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   Current UPMC employees must apply in HR Direct

Clinical Care Manager (RN) - Oncology Nurse Navigator

Description

UPMC is seeking a Clinical Care Manager - Nurse Navigator to work as part of a multidisciplinary care team providing Oncology case management at the Hillman Cancer Center.  The Nurse Navigator will provide high quality care coordination throughout a patient’s entire episode of care.  The ideal candidate will have extensive oncology nursing experience.


The Clinical Care Manager is responsible for care coordination and health education with identified Health Plan members through face to face collaboration with members and their caregivers and providers. This role identifies members' medical, behavioral, and social needs and barriers to care and develops a comprehensive care plan that assists members to close gaps in preventive care, addresses barriers to care, and supports the member's self-management of chronic illness based on clinical standards of care. Desired outcomes are achieved through collaboration and facilitation of care with other medical management staff, other departments, providers, community resources and caregivers to provide additional support. Members are followed by face to face interactions in their community including the hospital and other health care facilities.

Does this sound like the perfect opportunity for you? Apply today to connect with our team!

Responsibilities:

  • Consistently adhere to the UPMC goals of service excellence when interacting with patients, families, visitors, and staff.
  • Strictly adhere to UPMC patient and information per HIPAA confidentiality policies.
  • Maintain flexibility and awareness with changing workloads and patient activity.
  • Manage all assigned oncology patients throughout their episodes of care, utilizing an intra-collaborative approach.
  • Document activities in Aria to facilitate seamless communication with the oncologist, between providers and staff.
  • Prioritize service to members identified as at increased risk for ED use, hospitalizations, and readmissions. Several drivers of these outcomes were noted and include but may not be limited to comorbid conditions; toxicity of/morbidity associated with treatment regimen; disease stage/burden; compliance with treatment; and SDoH.
  • Deliver services or coordinate services (offered by other providers at the Cancer Center and/or the Health Plan) aimed at addressing these drivers.
  • Provide members, providers, and other stakeholders with accurate information concerning benefits and coverage in collaboration with the financial counselor.
  • Receive and respond to complex calls regarding requests for services or resolution of complicated issues.
  • Emphasize and educate patients on importance of clinical trials.
  • Identify all service-related issues and address with the supervisor so that they can be resolved quickly and efficiently to ensure that the patients receive appropriate, five-star, quality service.


Qualifications

  • Minimum of 2 years of experience in a clinical and case management nursing required.
  • 4 years of nursing experience in a hospital setting preferred.
  • BSN preferred.
  • Minimum 1 year of health insurance experience required.
  • 1 year of experience in clinical, utilization management, home care, discharge planning, and/or case management preferred.
  • Oncology nursing experience highly preferred.
  • Telephonic case management experience highly preferred.
  • Excellent organizational skills.
  • High level of oral and written communication skills.
  • Computer proficiency required.

Licensure, Certifications, and Clearances:

  • Case management certification or approved clinical certification required (or must be obtained within 2 years of hire to remain in role)
  • CPR required based on AHA standards that include both a didactic and skills demonstration component within 30 days of hire
  • Automotive Insurance
  • Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR)
  • Driver's License
  • Registered Nurse (RN)

UPMC is an Equal Opportunity Employer/Disability/Veteran

 

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   Current UPMC employees must apply in HR Direct

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