Oncology Case Manager

About the role

The Oncology Case Manager will manage enrolled oncology members, ensuring that treatment plans meet clinical and benefit criteria. This role involves applying Discovery Health protocols, communicating benefits, and providing counselling to members.

Key responsibilities

• Enroll members onto the Oncology program and verify eligibility (forensics, underwriting categories).
• Review treatment plans against SAOC and ICON guidelines and Discovery Health protocols.
• Approve compliant treatments and decline those that do not meet criteria.
• Refer complex cases to internal or external medical review teams and relay feedback to members and providers.
• Communicate funding decisions verbally or in writing to members, employers, and brokers.
• Document approval/decline decisions and the rationale behind funding outcomes.
• Identify and report clinical risk using professional knowledge.
• Provide support to members, CHO service agents, doctors, and pharmacists.
• Coordinate treatment plans with doctors and distribute updated guidelines.
• Meet daily operational targets.

Required profile

• Strong accountability and action‑orientation.
• Ability to manage ambiguity, complexity, and conflict.
• Business insight and customer‑focus.
• Effective communication and collaboration skills.
• Courage to make decisive, quality decisions.

Required skills