Oncology Nurse Consultant (RN)
100% Remote | Anywhere in the Contiguous U.S. | Oncology Care Model
Are you an experienced Oncology Nurse looking for an opportunity to make a meaningful impact throughout a patient's cancer journey? Join our innovative Oncology Care Model team and serve as a clinical leader, care coordinator, and utilization management expert, helping members navigate treatment, access appropriate care, and achieve the best possible outcomes.
About the Role
The Oncology Nurse Consultant serves as a hybrid Care Management and Utilization Management professional, providing comprehensive support to oncology members from diagnosis through treatment and recovery.
As part of an interdisciplinary team that includes a Medical Director, Nurse Practitioner, Pharmacist, Behavioral Health Specialist, and Oncology Companion, you will work collaboratively to ensure members receive evidence-based, coordinated, and cost-effective oncology care.
What You'll Do
Clinical Case Management
- Conduct comprehensive clinical assessments and identify members who would benefit from oncology case management services
- Develop, implement, and monitor individualized care management plans
- Assess medical, psychosocial, functional, and support needs throughout the cancer journey
- Advocate for members to maximize available healthcare benefits and services
- Support transitions of care, discharge planning, and ongoing treatment coordination
- Identify and escalate quality-of-care concerns through established channels
Oncology Care Coordination
- Serve as a trusted clinical resource for members and caregivers throughout treatment
- Coordinate care with oncologists, specialists, hospitals, providers, and community resources
- Evaluate members' health literacy, readiness for change, and support needs
- Provide education, coaching, and ongoing support to help members make informed healthcare decisions
- Utilize motivational interviewing techniques to improve engagement and treatment adherence
Utilization Management
- Perform utilization reviews and evaluate medical necessity for oncology-related services
- Apply evidence-based oncology guidelines and clinical criteria to support treatment decisions
- Leverage NCCN guidelines to assess treatment plans and support adherence to best practices
- Partner with Medical Directors and treating providers to review treatment exceptions and clinical variances
- Review medical records and clinical documentation to ensure appropriate utilization of healthcare resources
- Support cost-effective treatment recommendations while maintaining quality patient outcomes
Collaboration & Program Development
- Participate actively in multidisciplinary oncology team discussions
- Consult with providers, internal stakeholders, and healthcare partners regarding utilization management and care planning
- Contribute ideas and recommendations to improve program effectiveness and member experience
- Support organizational goals focused on quality, outcomes, and healthcare resource optimization
WHAT YOU BRING - REQUIRED
- Active, unrestricted RN license in state of residence
- Ability to obtain multi-state licensure upon hire
- Current Oncology Nursing Certification Corporation (ONCC) certification, including one of the following:
- OCN
- CPHON
- CBCN
- TCTCN
- AOCNP
- ROCNTM
- AOCNS
- AOCN
- 5+ years of oncology nursing experience
- 2+ years of Utilization Management experience
- Knowledge of:
- Oncology treatment protocols
- Cancer symptom management
- Supportive care services
- Evidence-based oncology guidelines
- Medical necessity criteria
- Experience collaborating with multidisciplinary healthcare teams
- Excellent clinical judgment, critical thinking, and communication skills
Preferred Qualifications
- Compact RN license
- Certified Case Manager (CCM) certification
- Telephonic case management experience
- Telephonic customer service or care management experience
- Managed Care experience
- Experience working remotely and independently
Education
- Associate Degree in Nursing required
- BSN preferred
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is
$60,522.00 - $129,615.00