RN Care Manager Neuro-Oncology

Cincinnati Children's•Burnet, TX

21h•$81,723 - $104,208•Onsite

About The Position

Coordinate Complex Care. Support Families. Make a Lasting Difference. At Cincinnati Children’s, we come to work with one goal: to make children’s health better. Our Cancer & Blood Diseases Institute provides nationally recognized, comprehensive care for children and adolescents with cancer and complex blood disorders. We are seeking a compassionate and highly organized Registered Nurse Care Manager to join our Neuro-Oncology team. In this role, you will serve as a trusted clinical resource and care coordinator for children with brain tumors and their families, partnering closely with two Neuro-Oncology physicians and a multidisciplinary team. This is a longitudinal care management role that follows patients across the continuum—from diagnosis and active treatment through therapy completion, surveillance, and long-term survivorship. You will manage a complex panel of approximately 500 patients, with responsibilities extending well beyond patient volume. The population includes children receiving active treatment, newly diagnosed and relapsed patients, patients receiving radiation or proton therapy, international patients, patients transitioning to hospice, and long-term survivors. You will help ensure that every patient and family has the appropriate resources, follow-up, education, and coordination needed throughout their care journey.

Requirements

5 years nursing experience
Current Registered Nurse license in the State of Ohio.
Bachelor of Science in Nursing (BSN).
Professional nursing experience with demonstrated clinical judgment and care coordination skills.
Strong organizational, communication, critical-thinking, and problem-solving skills.
Ability to independently prioritize and manage a complex patient population.
Ability to collaborate effectively with physicians, advanced practice providers, nurses, and multidisciplinary teams.
ACEN/CCNE accredited BSN OR MSN OR Associate/Diploma RN AND 2+ years of experience and BSN/MSN.
5+ years of work experience in a related job discipline.
Active Ohio RN License. May be required to obtain other state licensure.

Nice To Haves

Pediatric nursing experience.
Pediatric oncology or neuro-oncology experience.
Previous care management, nurse navigation, or nurse coordinator experience.
Experience caring for patients with complex medical and psychosocial needs.
Oncology or pediatric nursing certification.

Responsibilities

Manage a complex caseload of approximately 500 pediatric neuro-oncology patients across multiple phases of care.
Coordinate care for high-acuity patients, including those receiving active chemotherapy, newly diagnosed or relapsed patients, patients receiving radiation/proton therapy, and patients with complex medical and psychosocial needs.
Serve as a consistent point of contact for patients and families, helping them navigate the healthcare system and understand their individualized plan of care.
Coordinate care across oncology, neurology, neurosurgery, radiation/proton therapy, supportive care, survivorship, rehabilitation, and community resources.
Collaborate closely with two Neuro-Oncology physicians and multidisciplinary providers to facilitate timely care and follow-up.
Monitor treatment plans, diagnostic testing, appointments, referrals, and follow-up needs to identify barriers or potential delays.
Provide clinical triage, assessment, education, and support to patients and families.
Identify patients who are overdue for care or difficult to reach and conduct outreach to support re-engagement in care.
Coordinate transitions between active treatment, surveillance, survivorship, and end-of-life care.
Support patients and families experiencing complex psychosocial, emotional, and logistical challenges.
Facilitate communication among providers and ensure important clinical information is shared across the care team.
Help patients and families access appropriate hospital, community, financial, educational, and supportive resources.
Maintain accurate and timely documentation of care coordination activities and patient outcomes.
Advocate for patients and families while helping to ensure safe, equitable, and timely access to care.
Evaluate the timeliness and availability of treatments and services and adjusting level of service according to changing needs.
Evaluate actual patient outcomes in relation to expected outcomes for the care managed population.
Identifies quality improvement opportunities such as consistent issues with smooth care progression and communicates them to the department's management/leadership team, providing supporting data and reference to evidence based practice when possible.
Participates in the management of metrics (outcomes, value, and experience) across the continuum of care.
Monitor the patient's progress in achieving the goals, objectives, and expected outcomes of the plan at specified time frames.
Utilizes Critical Pathways and /or Clinical Guidelines to monitor patient progress toward health.
Follows through on the status of key diagnostic and treatment tests and procedures to insure continued progression.
Interacts with involved departments and other members of the healthcare team to negotiate and expedite scheduling and completion of tests and procedures.
Identifies, documents and communicates barriers to the plan of care to the healthcare team.
Serves as the contact person for and works collaboratively with the multidisciplinary team to manage resource usage/utilization.
Facilitates communication and coordination between members of the health care team across all phases of care.
Involves the patient, family and caregivers in the decision-making process in order to minimize fragmentation in services.
Leads the coordination of care, setting priorities and encouraging the appropriate use and timeliness of health care services
Facilitates a smooth transition of care by ensuring that key components of the plan of care and/or patient needs are communicated to subsequent care providers across the continuum.
Demonstrates an understanding of legal and regulatory issues (HIPPA, EMTALA, regulatory agencies, CMS, legal P&P) impacting the care delivery and reimbursement process.
Negotiates and advocates for the patient for services and resources needed.
Provides patient/family education regarding post-acute services, community resources, or other needs as identified.
Creates an environment to support patient safety by integrating patient safety goals into daily practice based on the patient's age and the population served.
Implementing the agreed upon plan of care.
Provides self-management support to high risk/complex patients and families, including helping families identify and overcome barriers to care.
Utilizes collaborative communication skills to establish a working partnership with the patient/family/caregiver, treatment team, and community resources/providers.
Educates the patient, family and caregiver along with members of the health care delivery team about treatment options.
Empowers the patient, family, and caregiver to problem-solve by exploring options of care when available and alternative plans, when necessary, to achieve desired outcomes.
Encourages the appropriate use of health care services and strives to improve quality of care and maintain cost effectiveness on a case-by-case basis.
Support and facilitate all care transitions from inpatient to outpatient, practice to practice and from pediatric to adult systems of care.
Planning with the patient, family or caregiver and providers, to maximize health outcomes and ensure quality, cost effective care.
Works with the patient, family and caregiver, to establish treatment goals that meet the patient's healthcare and safety needs.
Integrates patient, family and caregiver decisions and choice into the planning process.
Coordinates the plan of care and maintains documentation of case updates and discussion/events involving individuals responsible for patient welfare (e.g. family, providers, and care team members).
Identifies the need for patient/family team meeting, participates in the meeting and documents the outcomes.
Proactively identifies medical and psychosocial services needed by the patient.
Reassess plan of care and adjusts plan according to patient needs.