Medical Oncology Nurse

About OncoHealth OncoHealth is a leading digital health company dedicated to helping health plans, employers, providers, and patients navigate the physical, mental, and financial complexities of cancer through technology enabled services. Supporting more than 14 million people in the US and Puerto Rico, OncoHealth offers digital solutions for treatment review and virtual care across all cancer types. About the Role The Medical Oncology Nurse is responsible for using effective relationship management, education, patient advocacy and related interventions for oncology requests. Primary Responsibilities Obtain, review, present clinical or service information, and create specific letters in collaboration with pharmacy team and medical team members to enable medical decision on requested therapy Review supportive care drugs Review services such as site of care Review requests for medical necessity, referring to the Medical Director those that require clinical decision-making authority Create letters such as denials to support outcomes of cases Facilitate peer-to-peer phone calls to maximize patient outcomes Approve requests that meet clinical review criteria upon direction from the Medical Director Serve as initial clinical reviewer Build relationships with providers’ offices and staff Work closely with and provide advice and counsel to CRS team and other departments as needed Present clinical information to clinical staff to enable medical decision on requested therapy Maintain accurate records of all interventions and communications and provide timely verbal/written reports on each case Create Clinical Consultation Faxes Review medical records, laboratory results and other testing Manage assigned projects such as improved quality of care, workflow efficiency, promote cost effective medical outcomes, provide for continuity of care, assure appropriate levels of care are received by patients About You Bachelor’s degree or relevant experience required Must have current unrestricted Registered Nurse licensure recognized in the United States Minimum 2 years of experience in direct patient care or relevant educational attainment required Oncology Nursing experience preferred Knowledge of guidelines for, Medicare, Medicaid, LCD, NCD and Insurance guidelines Must have ability to demonstrate knowledge and skills needed to obtain clinical information for assessment Must be able to promote cost effective medical outcomes About the Location OncoHealth is committed to remote, hybrid or in office work options. The majority of the team will be remote or in hybrid work arrangements with offices in Atlanta, GA and Guaynabo, PR. We are open to employees nationwide but work primarily in the Eastern and Central Time Zones. Our Culture Taking ownership of quick action, critically thinking through the needs, and working well with others are key competencies of team member success. Our leadership is dedicated to building a culture based on respect, clinical excellence, innovation – all with a focused mission of putting patients first! We offer a full benefit package on your first day, along with a company bonus. You may visit or work from our very modern and engaging offices, and experience a fun, collaborative environment where social activities and community events matter. We enjoy being together! OncoHealth is committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and team members without regard to race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. All employment decisions are based on qualifications, merit, and business need. The Opportunity The cost of cancer related medical services and prescription drugs in the United States is expected to reach $246 billion by 2030. OncoHealth has enjoyed rapid growth over the past 3 years and seeks smart, collaborative people to join its team. We have just under 250 team members, so we can move swiftly but precisely to the market needs of our customers. Strongly backed financially by Arsenal Capital Partners & McKesson Corporation, we remain in an investment and growth mode. This means we are open-minded to how we get the work done – now is the perfect time to talk to us! Our Current Solutions Through the use of OncoHealth's utilization management system, OneUM , our customers can use a single e-Prior Authorization portal for all oncology drug request and treatments. Our system improves quality of care, reduces provider abrasion and gives health plans visibility into the total cost of oncology treatment. OncoHealth offers Oncology Insights Pro , an analytic software solution that enables health plans to use data and analytics to improve oncology programs. Using real world data, our engineers normalize data to create analytic dashboards with drill down compatibilities. The data is the paired with expert guidance providing the strategies an insight needed to keep up with the continuing evolving cancer treatment landscape. OncoHealth offers Pharmacy Consulting services to health plans and pharmaceutical companies. New cancer treatments are entering the market at an unrelenting pace. Since 2018, the FDA approved 121 new cancer applications including 49 novel cancer drug entities. Our Board-Certified Oncology Pharmacologists can help health plans update drug policies, offer utilization management and formulary advice, and development training for staff. OncoHealth's latest offering is Iris , a digital telehealth platform that delivers personalized, oncology-specific support to navigate the physical symptoms and emotional challenges caused by cancer and cancer treatment. Powered by technology, staffed 24X7, and delivered with empathy, Iris allows patients to connect with trained oncology experts and receive personalized, oncology-specific telehealth support.