Case Management Officer, NCIS 1 1 1

Overview*

The National University Cancer Institute, Singapore (NCIS) is a national specialist centre under the National University Health System (NUHS). It is the only public cancer centre in Singapore treating both paediatric and adult cancers in one facility.

We are seeking an outstanding and highly motivated Care Coordinator to be part of our incredible team, supporting NCIS in the deliveries of FY30 work plan.

A care coordinator navigates the cancer patient and family through the health system and optimize the individual's health and well-being at various phases across the continuum of cancer care, including diagnosis, treatment, rehabilitation, follow-up, survivorship and palliative care.

Close communication with the patient across the care continuum to ensure care coordination, efficient care delivery, and removal of care barriers.

To oversee and facilitate the running of 3 parallel studies that aims to evaluate the management of cancer patients in the outpatient setting via telehealth and remote vitals monitoring.

Job Responsibilities*

A. Direct care

• Assist case management officer to facilitate cancer navigation by working with the NCIS Nurse in the following areas:
• Provide individualized assistance (informational and emotional support) to patients and their families to overcome healthcare system barriers, improve continuity of care and quality of cancer care.
• Identify and navigate needy (high-risk) patients through the journey to ensure that they do not fall through the gaps and have access to the resources they need.
• Follow-up with patients through phone, where necessary. This will enable patients easier access to the medical team hence reducing unnecessary re-attendances to Emergency Department and potential admissions.
• Assist patients and their families to transit across different services and location.
• Communicate effectively with health care professionals in providing smooth transitions.
• Perform assessment to identify patients' physical, psychosocial and spiritual needs, and barriers in accessing to health care system. Initiate interventions to address the identified barriers, and in meeting the physical, psychosocial and spiritual needs.
• Perform patient navigation outcomes evaluation.
  • Assist case management officer on coordination of care
    • Ensure compliance to care pathways and to streamline cancer care between NUH and NTFGH.
    • Ensure smooth transition of care and right-siting of patients based on care pathways.
    • Ensure timely and appropriate referral to specialist, allied health and support services.
    • Assist in coordination of care between services (medical, surgical or allied), and between settings (inpatient, outpatient and community).
    • Involve in close liaison with Medical Oncologists, Surgical Oncologists, Radiation Oncologists, Radiologists and other specialists, involved in the patient's care.
    • Perform outcomes evaluation of care pathways.

3. Assist case management officer in Tumor board management

• Tumor board coordinator for the weekly tumor board.
• Assist in coordination of care between services (medical, surgical or allied health) based on decisions made at the weekly tumor board.
• Ensures tumor board database is complete.
• Manage and audit tumor board database.

4. Assist Cancerline nurses in the management of patients on TrAlge, TEMPO and Chatbot studies.

• Main point of contact for all 3 studies.
• Facilitate communications between trial coordinator (for consenting) and also NUHS@Home coordinator.
• Help to screen patients who qualify for these TrAlge and administer screening questionnaire to primary physicians.
• Help input vitals from chat into EPIC (manual phase).
• Help call/remind patients who did not input their vitals on time.
• Administer user questionnaire.

B. Education

Assist case management officer:

• Patient education
  • Patient and family education pertaining to cancer journey.
  • Triage patients to subspecialty care resources (eg. stoma nurse, oncology APN, MSW, financial counsellor, etc.).
  • Advise and guide patients regarding estimated treatment costs and financial counselling.
  • Develop and update patient education materials in collaboration with multidisciplinary team.

Assist Cancerline nurses in the management of patients on TrAlge and TEMPO studies:

1. Patient education

• Onboarding of patient – explanation of trial procedures and schedule.
• Explanation of use of medical equipment e.g. blood pressure machine, pulse oximeter.
• Offboarding of patient – to follow up with symptom specific evaluation checklist and red flags, ensure sufficient medications and reminder of next upcoming appointment.

2. Staff resource

• Advise and guide clinic staff regarding cancer treatments, procedures and estimated cost for financial counselling.
• Support multidisciplinary team members pertaining to patient care matters.

C. Data management

Assist case management officer:

• Obtain key clinical and operational data at checkpoints (transitional points along patient journey) and enter into cancer database in a timely manner.
• Compile data (from care pathways) in NUH and NTFGH (collaborating with Cancer Survivorship Program Coordinator) and build database with annual audits.
• Compile basic data collection for TrAlge, TEMPO and Chatbot projects.
• Assist in simple data analytics and participate in quality improvement projects that aim to improve coordination of care and optimize outcomes for individual and services.
• Work with VDO teams to measure tumor group outcomes.

D. Research

Assist case management officer:

• Liaise with research assistants, residents and research fellows working on projects related to cancer and supportive care.

E. Leadership and professional development

• Facilitate quality improvement activities.
• Assist in design and facilitate role and service expansion in cancer care coordination and cancer navigation.
• Participate and facilitate strategic planning in cancer care.

F. Any other tasks as assigned by RO (approximately 20%)

Requirements

• A recognised degree in Health Sciences preferably in Degree in Nursing or Allied Health relevant to the job.
• Candidates with relevant working experience in a similar setting preferred.
• Possess good interpersonal, strong team spirit and communication skill.
• Possess good computer knowledge and Microsoft words skills.
• Able to multi-task and work under stress.