Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members.

Full Time Employees of Confluence Health receive a wide range of benefits in addition to compensation.

• Medical, Dental & Vision Insurance
• Flexible Spending Accounts & Health Saving Accounts
• CH Wellness Program
• Paid Time Off
• Generous Retirement Plans
• Life Insurance
• Long-Term Disability
• Gym Membership Discount
• Tuition Reimbursement
• Employee Assistance Program
• Adoption Assistance
• Shift Differential

For more information on our Benefits & Perks, click here!

The Oncology Nurse Navigator (ONN) is a professional RN with oncology-specific clinical knowledge who offers individualized assistance to patients, families, and caregivers to help overcome healthcare system barriers. Using the nursing process, an ONN provides education and resources to facilitate informed decision making and timely access to quality health and psychosocial care throughout all phases of the cancer continuum, from diagnosis through treatment to survivorship care. The ONN provides longitudinal comprehensive nursing care to a designated case of oncology patients. As the primary point of contact for complex outpatients, the ONN provides continuity of care through nursing assessments, triage, patient education and care coordination. The ONN is an integral part of a dedicated multidisciplinary team which collaborates closely to provide the highest level of care for patients.

Position Reports To: Clinical Practice Manager

1. Demonstrates a high level of understanding of oncology illnesses and treatment modalities.
2. Demonstrates the ability to assess baseline physical, emotional and social needs.
3. Provides clinical and technical oversight and education of symptoms related to patients undergoing treatment for a variety of cancers requiring infused or injected chemotherapy, biologic therapy, blood products, and other agents
   • Manages patient symptoms, concerns and/or reactions and effectively communicates the entire picture to nurse navigator and/or provider for that patient.
   • Demonstrates ability to effectively intervene and direct colleagues during a patient crisis.
   • Provides patient and family education about treatments and side effects, procedures such as bone marrow aspiration and ommaya taps/intrathecal chemotherapy in collaboration with the other members of the healthcare team.
   • Informs Clinical Practice Manager and Provider of high-risk patient situations.
4. Manage, develop, implement, and evaluate initial patient plan of care following clinical pathways in collaboration with the Oncology Physician, and the health care team, to determine the effective utilization of resources and outcome achievement.
   • Obtain, review, and scan outside patient records for new newly referred oncology patients.
   • Determine need for further diagnostic work-up; communicate and coordinate necessary tests or procedures to the patient and the healthcare team. This includes coordination of provider orders from both inside and outside the system.
   • Coordinate simple and complex patient care issues in conjunction with other parts of the healthcare system, working inter-departmentally.
   • Determine timeliness/time appropriateness of appointments.
   • Ensures effective and appropriate utilization of resources and efficient patient throughput along continuum of care.
   • \Document interim progress notes reflecting coordination of care/services. Intervene when the clinical pathway is not being followed, either due to patient constraints or ineffective follow-through.
   • Collaborates with the healthcare team to make appropriate referrals to other healthcare settings and community resources.
   • Provide triage services and symptom management to patients as needed, in-person and over the phone. Communicate symptomology to appropriate team members.
   • Conduct toxicity checks/assessment on patients.
   • Ongoing assessment of patients for unmet social needs with appropriate referral and communication to social services, community resources, etc.
5. Monitor continuity of care and expedite delivery of services to move patients through the system effectively.
   • Develops, implements, and updates clinical care pathways for Oncology Care with Practice Manager, Physician, and healthcare team.
   • Identify and document variances from pathways and collaborate with the health care team in relation to patients' progress.
   • Assist with care coordination between radiation and medical oncology departments, including SCCA and affiliate partners.
   • Collaborates with staff in the different departments on clinical and operational issues to ensure timely and appropriate patient throughput in the healthcare system.
   • Collaborates with the health care team as needed to facilitate patient's care across the healthcare continuum.
   • Ensure that patient and family have received appropriate education and instructions in collaboration with health care team. This includes patient teaching on the disease, treatment options, procedures, and chemotherapy regimens and side effects.
   • Assess and coordinate patients receiving radioactive pharmaceuticals and oral chemotherapies.
   • Facilitate and/or conduct patient, family, and team conferences and rounds to develop and monitor a plan of action as necessary.
   • Appropriately assess and refer patients to support services, including social services, palliative care, survivorship, home health, hospice, etc.
   • Conduct Advance Care Planning discussions with patients and family members.
   • Aggregate data to identify patterns/trends of screening patients and delivery of care, report the data to appropriate administrative bodies, and facilitate change when necessary.
   • Document all care appropriately in the patient EMR.
   • Attend weekly tumor board meetings and other coordination meetings as needed to assist with the coordination of patient care and/or community support.
6. If the role includes survivorship navigation the essential functions will include duties which assist coordination of care for patients in the survivorship program.
   • Reaches out to patients who are appropriate for survivorship program to inform them what the components of the program are and encourage them to take part in it.
   • Assists and supports patients who are referred to survivorship to coordinate for the initial survivorship visit or other survivorship services.
   • Prepares individual treatment summaries and care plans for patients.
   • Member of survivorship task force for Oncology Service Line.
   • Involved in data collection for survivorship program.
   • Coordinates and communicates with other departments outside the Oncology Service Line who provide service for oncology patients to encourage knowledge and utilization of survivorship program.
7. Takes an active role in professional development to stay current with medications, oncology care and treatment and current standards of ONS, ASCO, and AONN.
8. Serves as resource in their area of expertise for staff and colleagues as a SCCA affiliate partner.
9. Actively engages in PI and LEAN processes.
10. Demonstrates effective and professional communication and collaboration with colleagues and providers.
11. Assures the safety of patients and other staff.
    • Follows all policy and procedures of the Medical Center related to verification of orders and products when administering chemotherapy, biotherapy, and other infusion agents.
    • Demonstrates an awareness of the potentially hazardous nature of many of the agents administered and follows safe handling and disposal policy and procedures of the medical center.
    • Prepares and protects patients and families during infusions through the strict adherence of the infection control policy, universal precautions, and standards applied to procedures of the Medical Center and the Oncology Department.
12. Required to maintain active Basic Life Support (CPR) certification.
13. Other duties as assigned.

Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.

Required:

• Current Washington State Nursing License.
• Current BLS Health Provider card.
• 3 years of clinical experience.
• Working knowledge of case management with clinical pathways.
• Knowledge of variance identification/reporting and process improvement.
• Working knowledge of team building and facilitation skills.
• Competent in basic computer skills.
• Ability to work independently and to use critical thinking; the ability to practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge.
• Ability to develop clinical judgment.
• Ability to communicate effectively by looking and listening for cues, asking open-ended questions, exploring cues, using pauses, screening responses, and clarifying response.
• Ability to effectively listen by using reflecting, acknowledging, summarizing, empathizing, and paraphrasing skills.
• Ability to effectively provide information by checking what information the person knows already, giving small amounts of detail at a time, using clear terms, avoiding jargon, avoiding detail unless requested, checking for understanding, pausing, and waiting for a response.
• Ability to effectively utilize time management skills; the ability to organize and manage time constraints, to independently manage tasks including basic computer skills and EMR.
• Demonstrates capability to multitask with accuracy and deal effectively with unpredictable situations.

Desired:

• AONN Certification
• Case Management experience/certification preferred.
• Oncology experience preferred.

O = Occasional, represents 1 to 25% or up to 30 minutes in a 2 hour workday.

F = Frequent, represents 26 to 50% or up to 1 hour of a 2 hour workday.

C = Continuous, represents 51% to 100% or up to 2 hours of a 2 hour workday.

Physical/Sensory Demands For This Position:

• Walking - F
• Sitting/Standing - C
• Reaching: Shoulder Height - F
• Reaching: Above shoulder height - O
• Reaching: Below shoulder height - O
• Climbing - O
• Pulling/Pushing: 25 pounds or less - F
• Pulling/Pushing: 25 pounds to 50 pounds - O
• Pulling/Pushing: Over 50 pounds - O
• Lifting: 25 pounds or less - F
• Lifting: 25 pounds to 50 pounds - O
• Lifting: Over 50 pounds - O
• Carrying: 25 pounds or less - F
• Carrying: 25 pounds to 50 pounds - O
• Carrying: Over 50 pounds - O
• Crawling/Kneeling - O
• Bending/Stooping/Crouching - O
• Twisting/Turning - O
• Repetitive Movement - F

Working Conditions:

• Not Specified.

Job Classification:

• FLSA: Non-Exempt
• Hourly/Salary: Hourly

Physical Exposures For This Position:

• Unprotected Heights - No
• Cold - No
• Heat - No
• Hazardous Substances - No
• Blood Borne Pathogens Exposure Potential - Yes
• Lighting - No
• Noise - No
• Ionizing/Non-Ionizing Radiation - Yes
• Infectious Diseases - Yes