Complex Case Manager RN - Oncology (Remote)

Lensa; Lincoln (NE); Remote; USD 75,000 - 95,000; Full time

Job summary

A leading healthcare organization is seeking a Complex Case Manager RN specializing in Oncology. This remote role involves managing patient care, developing care plans, and collaborating with a multidisciplinary team to improve health outcomes. Ideal candidates will have extensive experience in clinical settings and a strong understanding of healthcare regulations. Join a dynamic team dedicated to enhancing patient care and outcomes.

Qualifications

• 7 years in clinical, case management, or health insurance required.
• Oncology experience and case management certification preferred.

Responsibilities

• Manage a panel of members with varying health statuses.
• Develop care plans and monitor outcomes.
• Document activities in compliance with standards.

Skills

Communication

Negotiation

Interpersonal Skills

Organizational Skills

Time Management

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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Company: Highmark Inc.

Job Description:

This role involves managing a 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 collaborates with a multidisciplinary team to refer members to appropriate resources. Responsibilities include developing care plans, encouraging behavior change, addressing barriers, coordinating care, and monitoring outcomes to improve clinical, financial, and functional results.

Essential Responsibilities:

• Oversee a panel of members by assessing their health management needs and triaging to resources.
• Create and implement care plans with goals and regular re-assessment contacts.
• Achieve targeted patient outcome goals.
• Document activities in compliance with standards and regulations.
• Maintain knowledge of relevant healthcare regulations and standards.
• Perform other duties as assigned.

Education:

• Required: High School Diploma/GED

Preferred: Bachelor's Degree in Nursing

Experience:

• Required: 7 years in clinical, case management, disease management, provider operations, or health insurance.

Preferred: Experience with cognitive behavioral therapy, motivational interviewing, or dialectical behavior therapy; working with diverse populations; understanding cultural competency.

Licenses and Certifications:

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

Preferred: Oncology experience; certification in case management.

Skills:

• Excellent communication, negotiation, and interpersonal skills.
• Knowledge of disease processes and healthcare costs.
• Proficiency in MS Excel and data analysis.
• Strong organizational and time management skills.
• Self-directed with the ability to work independently.

Additional Details:

• Travel: 0-25%
• Position Type: Office-based
• Physical demands include lifting up to 25 pounds rarely.

Note: This description summarizes essential duties and may not include all responsibilities. Employees must adhere to ethical, legal, and confidentiality standards, including HIPAA compliance.