Complex Case Manager RN - Oncology (Remote)

Lensa; Denver (CO); Remote; USD 75,000 - 95,000; Full time

Job summary

A leading healthcare organization is seeking a Complex Case Manager RN to oversee a panel of members with diverse health statuses. This role involves assessing needs, developing care plans, and coordinating care to improve health outcomes. Candidates should have significant clinical experience and strong communication skills. The position is remote with occasional travel requirements.

Qualifications

• 7 years of clinical, case management, or related experience required.
• Oncology experience and case management certification preferred.

Responsibilities

• Manage a panel of members, assess health needs, and identify interventions.
• Create care plans and achieve targeted patient outcomes.
• Stay current with regulatory requirements and standards.

Skills

Communication

Negotiation

Interpersonal Skills

Organizational Skills

Multitasking

Education

High School Diploma/GED

Bachelor's Degree in Nursing

Tools

MS Excel

Job description

Complex Case Manager RN - Oncology (Remote)

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Highmark Health, is seeking professionals. Apply via Lensa today!

Company: Highmark Inc.

Job Description:

JOB SUMMARY

This role involves managing a specific panel of members with varying health statuses and clinical needs. The incumbent assesses health management needs, utilizes data and clinical judgment to identify interventions, and refers members to appropriate resources. They will develop care plans, encourage behavior changes, address barriers, coordinate care, and monitor outcomes to improve health, financial, and functional metrics.

ESSENTIAL RESPONSIBILITIES

• Oversee a panel of members, assess health needs, and identify suitable interventions or referrals.
• Create and implement care plans, set goals, and conduct regular re-assessments.
• Achieve targeted patient outcomes and document all activities in compliance with standards.
• Stay current with regulatory requirements and standards of practice.
• Perform other duties as assigned.

EDUCATION

• Required: High School Diploma/GED

Preferred: Bachelor's Degree in Nursing

EXPERIENCE

• Required: 7 years of clinical, case management, or related experience

Preferred: Experience with cognitive behavioral therapy, working with diverse populations, and understanding cultural competency.

LICENSES AND CERTIFICATIONS

• Required: RN license in PA, WV, DE, or NY (other states to be obtained within 6 months)

Preferred: Oncology experience and case management certification.

SKILLS

• Excellent communication, negotiation, and interpersonal skills.
• Knowledge of disease processes and healthcare costs.
• Proficiency in MS Excel and data analysis.
• Organizational and multitasking abilities.
• Self-motivated with the ability to work independently.

OTHER INFORMATION

Travel: 0-25%

Position Type: Office-Based, with occasional travel and training responsibilities.

Physical demands include lifting up to 10 pounds rarely.

Note: This description provides an overview of essential duties and may not include all responsibilities. It complies with legal and ethical standards, including HIPAA and data security policies.