[Hiring] Oncology Nurse Consultant @CVS Health

Role Description

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.

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.

Qualifications

• 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.

Benefits

• Fully remote opportunity available nationwide.
• Become part of a newly developed Oncology Care Model.
• Work alongside a specialized oncology care team.
• Combine Oncology Case Management and Utilization Management expertise in one role.
• Build meaningful relationships with members throughout their cancer journey.
• Influence quality outcomes, treatment adherence, and member satisfaction.
• Make a lasting impact during one of the most important times in a member's life.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $60,522.00 - $129,615.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Company Description

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.