Nurse Navigator

Job Summary

Optime Care Specialty Pharmacy is looking to hire a Nurse Navigator. This Nurse Navigator would be responsible for oversight and implementation of clinical support, education, case management and follow up with patients and physicians.

Responsibilities and Duties

• New patient welcoming and creating patient profile, including insurance information
• Conducting benefits investigations for patients insurance
• Act as patient advocate to gain insurance coverage for prescribed therapies

• Interpreting, assessing and conducting clinical educational support for patients and physicians
• Management of patients cases
• Respond to PA denials and submit Appeals, collecting appropriate clinical support to substantiate the formal response
• Strong telephonic patient care skills
• Maintenance and upkeep of appropriate documentation required by the state and federal agencies
• Ensuring that their professional license is kept current and they are well versed in current clinical practice regulations and guidelines

Qualifications and Skills

• RN or Bachelors of Nursing degree preferred
• Minimum of five (5) years’ experience in the field of nursing
• Oncology experience preferred
• Direct patient experience with oral, subcutaneous and/or IV medications preferred
• Ability to write reports, business correspondence and procedure manuals
• Experience with utilizing and developing patient assessments and questionnaires
• Ability to assess and advise patients via conversation
• Knowledge to effectively present information and respond to questions from groups of managers, patients, nurses and physicians
• Ability to define problems, collect data, establish facts and draw valid conclusions
• Current license for state practices
• Ability to work independently

• Excellent oral and written communication skills
• Excellent organizational, plus interpersonal skills
• Ability to maintain a leadership role
• Reasonable knowledge of information systems and software applications such as text documents, slide presentations and spreadsheets

Job Type: Full-time

Schedule:

• 8 hour shift
• Day shift
• No weekends

Work Location: One location