Jobs in Providence, United States

Infusion Referral Nurse Sr- REMOTE/Oncology exp required. Under supervision, responsible for performing referral services to support independent physician offices with maintaining member drug infusions in office or to help offices locate a lower cost alternative treatment site (e.g., home infusion) for drug infusion services versus the hospital outpatient facility. Discusses financial and clinical considerations with members considering care at a higher cost treatment site, researches available financial programs to decrease member out-of-pocket expense for drug services in office, and coordinates lower cost site of service for drug administration if provider is referring due to convenience factors (e.g., distance, non-typical infusing provider). Performs functions under supervision.

• Provides site of service solutions to patients seeking care at non-preferred treatment sites (e.g., hospital inpatient or outpatient facilities, non-par cancer treatment centers, etc.).
• Discusses the financial aspect of specialty drugs with the member and the ordering physician (or office staff); coordinates drug infusion at an alternate lower-cost site and concomitant services to support infusion administration in lower-cost sites.
• Provides resources to optimize treatment outcomes by utilizing critical thinking skills and providing specific resources related to complex illness.
• Supports member copay-assistance programs; researches and coordinates to decrease member out-of-pocket financial responsibility in an office or home setting for drug services.
• Maintains a required case load and activities to reach goals of switching site of service treatment to a lower-cost setting while maintaining member satisfaction.
• Documents and enters data of these cases in web-based applications and spreadsheets.
• Supports clinical services such as the appeals program.
• Participates in meetings and consults with management on member interaction and program outcomes.
• Maintains appropriate par levels of literature and stays familiar with community resources, benefit information, or other program-valued information.
• Maintains an active case load and accurate case records, adhering to company policies and laws governing patient records, including daily activity documentation.
• Performs related duties as requested.
• Clinical and quality oversight for this program is provided by the Manager, Patient Programs.

• Associates – Nursing
• Bachelors – Nursing
• RN – Registered Nurse, state and/or compact state licensure – Care Management
• 5+ years clinical experience

Must be eligible to work in the United States without the need for work visa or residency sponsorship

• Registered Nurse (RN).
• Oncology experience.
• Experience with chemotherapy drugs.
• 5 years of post-degree clinical experience.
• Experience in managed care, specialty drugs, care management, and utilization review.
• Meets credentialing criteria; active nursing license.
• Ability to apply knowledge to clinical findings from evidence-based guidelines.
• Ability to function independently and as a team member.
• Good organizational, time-management, and communication skills.
• Ability to develop effective teams to achieve organizational goals.
• Comprehensive clinical knowledge of medical specialty drugs and their management.
• Understanding of the clinical aspect of infusion of those drugs at various sites of service.

Security responsibilities and controls, compliance with applicable legal and regulatory requirements, and adherence to internal policies and procedures.

Eligible employees must be able to perform essential job functions; reasonable accommodations will be made where needed unless it causes undue hardship. Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $74,000.00 – $118,000.00 based on experience and skills. For details, review our Benefits Page and Benefits at a glance.

Prime Therapeutics LLC is an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration regardless of race, color, religion, gender, sex, national origin, disability, age, veteran status, or other legally protected status. We welcome applicants with arrest and conviction records and offer reasonable accommodations as required by law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.