JOB SUMMARY:

The Oncology APP/Navigator provides individualized care coordination to patients, families, and caregivers. Works under the supervision of a physician to provide direct patient care, patient and family education, psychological support, and survivorship planning for both medical oncology and radiation oncology patients from the time of diagnosis throughout the continuum of cancer care. The advanced practice professional scope of practice includes performing comprehensive assessments and physical examinations, ordering and interpreting diagnostic laboratory tests, performing invasive procedures, prescribing medications and treatments, ordering chemotherapy and biotherapy regimens, conducting health screenings, and providing patient and family education. The advanced practice professional serves as an educator, consultant, and liaison to healthcare providers caring for the patients across the continuum of care, which can include inpatient and outpatient services. The advanced practice professional performs administrative duties, including quality improvement activities, teaching, and hospital committee membership. In some states, advanced practice professionals provide care and management of patients in collaboration with supervising physicians and through implementation of standardized procedures.

JOB QUALIFICATIONS

Licensure to practice and prescribe medications as an FNP in the State of Wyoming.  Certification in ACLS and BLS.  Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined. 

REQUIRED EDUCATION:

• Master’s or doctoral degree from a program accredited by the Accreditation Commission for Education in Nursing or the Commission on Collegiate Nursing Education, an accrediting arm of the American Association of Colleges of Nursing
• Two years of related experience as an RN in an oncology setting is preferred
• At least two years of successful practice as a nurse practitioner, preferably with experience in hematology-oncology
• National board certification as a nurse practitioner from an agency accredited by the American Board of Nursing Specialties
• Position requires Nurse Practitioner certification in oncology upon eligibility within three years of hire.
• Obtain chemotherapy/immunotherapy certificate (through ONS/ONCC or HCH), renewed every two years.
• State nurse practitioner licensure
• U.S. Drug Enforcement Administration licensure for prescription of schedule II–V controlled substances, required only if prescribing controlled substances to outpatients

All Nurse Practitioners must be appropriately credentialed through the Medical Staff Credentialing process and abide by all Medical Staff Bylaws and Rules & Regulations. 

ESSENTIAL JOB FUNCTIONS:

1. Assesses the physical condition of patients by performing physical examinations and obtaining complete medical, family, and social histories. 
2. Formulates the medical plan and prognosis based on patient’s condition.
3. Consults with physician(s) regarding patient health care plans and treatment.
4. Orders, interprets, and evaluates diagnostic tests to identify and assess the patient’s clinical problems and health care needs.
5. Performs other therapeutic or corrective measures as indicated, including urgent care interventions as necessary,
6. Initiates and/or recommends medical drug therapies or other forms of related therapeutic treatment and procedures in accordance with approved protocols/policy.
7. Initiates and maintains required medical records and legal documents.
8. Complies with medical records policies regarding the complete and accurate documentation of patient care. 
9. Participates in quality improvement activities.
10. Counsels patients, families, and significant others about health and illness, and promotes health maintenance.
11. Evaluates, plans, implements, and re-evaluates the care of individuals requiring emergency measures.
12. Responsible for the correct administration of prescribed medication administered on site.
13. Works collaboratively with all members of healthcare team.
14. Performs other duties as assigned.
15. Proficiency in clinical management of complex patients
16. Current knowledge of the latest trends, skills, procedures, and protocols in hematology-oncology and internal medicine practice
17. Ability to communicate with members of the interprofessional team with written and verbal proficiency
18. Knowledge and skills necessary to provide care to patients within specific age groups, human development stages, and cultural groups
19. Ability to discuss sensitive topics, such as sexuality and end-of-life concerns
20. Knowledge of clinical guidelines for survivorship care and treatment
21. Awareness of quality benchmarks for oncology care
22. Experience with conflict resolution
23. Integrity and trustworthiness in resolving problems
24. Skill in coordinating oncology patient care with other interprofessional staff
25. Skill in interpersonal relationships, program development, critical thinking, and problem solving
26. Strong ability to use data, computer systems, and electronic health records in support of care delivery
27. Proficiency in billing rules and regulations
28. Willing to coordinate days off with physician to ensure provider coverage

RESPONSIBILITIES:

Clinical

• Manages the clinical course of patients with cancer with acute or chronic complaints and end-of-life and other health concerns.
• Communicates and interacts effectively with patients, families, and staff, considering cultural differences.
• Formulates an evidence-based treatment plan according to the interpretation and evaluation of all patient data.
• Manages cancer survivors by performing a cancer-related review of systems to detect late and long-term effects of cancer treatment.
• Performs comprehensive history and physical examinations on patients with cancer to assess normal and abnormal findings and identifies differential diagnoses on established and new patients.
• Recognizes and initiates lifesaving procedures for oncologic emergencies and brings emergencies to the immediate attention of a physician.
• Performs invasive procedures such as bone marrow biopsies, paracentesis, thoracentesis, and lumbar punctures after competency has been confirmed.
• Initiates arrangements for hospital admissions and discharges patients as indicated by clinical status.
• Performs core clinical practice competencies specific to the patient population.
• Collaborates with other healthcare team members involved in patient treatment to ensure continuity of care.
• Triage and evaluate patients, when needed, and provide and/or write orders specific to patient’s needs.
• Facilitates the coordination of advanced practice professional inpatient and outpatient care and services.
• Fosters an environment of respect for patient privacy.
• Obtains informed consent as indicated.
• Orders and interprets diagnostic tests, orders blood products, collects specimens for routine laboratory tests, and performs screening and therapeutic procedures.
• Orders consults for services such as physical therapy, occupational therapy, respiratory therapy, imaging studies, and nursing services.
• Prescribes medications and administers orders as indicated by patients’ clinical status.
• Presents cases to the tumor board.
• Promotes, directs, evaluates, and manages safe patient care for patients being treated in the chemotherapy unit.
• Provides and coordinates patient teaching and counseling.
• Provides clinical support for independent practice in an oncology nurse practitioners/physician assistant–­led clinic service model to treat patients for symptoms related to their disease and to assist the flow of patients who have oncologic or hematologic diagnoses.
• Provides patient consultation via telephone or social media as permitted.
• Participates in rounds with the interprofessional oncology team.
• Serves as a cancer pain management resource to the medical center in outpatient and inpatient settings.
• Uses and promotes approved standards of care, procedures, methods and techniques, safety precautions, and protocols in their application to the oncology patient population in all settings.
• Writes orders and consultations to radiation oncology, writes orders for vascular access device placement for chemotherapy, and arranges for procedures and biopsies with the surgery and interventional radiology departments.
• Writes orders for administration of blood products and chemotherapy agents under the direction and supervision of attending physicians.

Navigation

• Leads the oncology navigation team and holds regular meetings.
• Transitions patients from one phase of care to the next, including self-management and independence in self-care.
• Matches unmet needs with referrals to a social worker, dietitian, genetic counselor, nurse practitioner, and community or outreach coordinator.
• Facilitates scheduling of appointments for clinical consultations and support services inclusive of the medical care team, surgeons, radiation oncologists, social workers, pain consults, and dietitians.
• Follows patients throughout the care continuum, including inpatient admissions, and collaborates with inpatient care management resources.
• Assists patients to make informed decisions.
• Conducts initial and ongoing comprehensive needs assessments of patients and families.
• Follows an intervention plan from the time of patient referral, coordinates care among team members, reviews patients’ disposition for care, provides patient information and education, assists patients in obtaining a second opinion, follows patients during treatment, and evaluates care and changing priorities.
• Provides emotional and educational support for patients and families.
• Identifies new and established patients with a cancer diagnosis who require navigator services.
• Encourages patients and families to participate in the care plan.
• Collaborates with members of the healthcare team to design and coordinate an evidence-based plan of care.
• Documents in the electronic health record, as indicated, all interventions and clinical changes using established care guidelines.
• Evaluates results of care plan and adjusts priorities as patient status changes.
• Participates in patient education by assisting patients in understanding diagnoses, treatment options, and available resources.
• Uses a case management system.

Leadership and Quality

• Adheres to established productivity benchmarks, quality metrics, and clinical outcomes and submits data for the oncology dashboard.
• Articulates service and customer relations improvements to ensure patient retention.
• Coordinates clinical information for multidisciplinary treatment-planning cancer conferences.
• Develops patient education programs and written communication materials.
• Participates in oncology service line performance improvement activities.
• Assists with chart abstractions for QOPI certification.
• Maintains responsibility for outreach efforts to establish and maintain positive working relationships with key stakeholders (e.g., physicians, office staff, diagnostic laboratory staff, nurses, radiology staff, social services staff, radiation oncology staff).
• Attends monthly medical oncology meetings, monthly cancer center meetings, weekly chart rounds for radiation oncology to discuss concurrent patients, weekly provider touch base meetings, navigation meetings, new patient orientation meetings, etc.

Administration, Education, and Research

• Promotes and participates in the delivery of patient and family education on the cancer diagnosis, treatment, expected outcomes, and end-of-life issues, such as do-not-resuscitate orders, healthcare proxies, and advance directives.
• Assists with completion of patients’ disability and insurance forms as needed.
• Mentors other staff and advanced practice colleagues as appropriate.
• Participates in clinical research studies as determined by the needs of the program.
• Participates in staff development and in-service education as requested.
• Completes the clinical trial education and maintains registration annually
• Reviews patient eligibility for clinical trials.
• Is a member of the Clinical Trial Team as a coordinator and performs such duties, when needed.
• Submits billing documentation within the employment model and state and Centers for Medicare and Medicaid Services regulations.