Complex Case Manager RN - Oncology (Remote)

Lensa; Nashville (TN); Remote; USD 75,000 - 95,000; Full time

Job summary

A leading healthcare company is seeking a Complex Case Manager RN specializing in Oncology. This remote role focuses on managing patient care through assessments, care plans, and collaboration with a multidisciplinary team to improve health outcomes. Ideal candidates will possess strong communication and organizational skills, along with extensive experience in clinical settings. Join a dedicated team committed to enhancing patient health and well-being.

Qualifications

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

Responsibilities

• Manage a panel of members by assessing their health needs.
• Create and implement care plans with short and long-term goals.
• Document all activities in compliance with standards.

Skills

Effective communication

Negotiation

Interpersonal skills

Organizational skills

Time management

Self-directed

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 panel of members with varying health statuses and clinical needs. The incumbent assesses health management needs, utilizes data and clinical judgment to identify appropriate interventions, and coordinates with a multidisciplinary team to support members. Responsibilities include developing care plans, encouraging behavioral changes, addressing barriers, coordinating care, and monitoring outcomes to improve health, financial, and functional metrics.

ESSENTIAL RESPONSIBILITIES

• Oversee a panel of members by assessing their health needs and referring them to appropriate resources.
• Create and implement care plans with short and long-term goals, including regular re-assessments.
• Achieve targeted patient outcome goals, including care plan realization.
• Document all activities in compliance with organizational, regulatory, and accreditation standards.
• Stay updated on CMS, state, local, and professional standards for case management.
• 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, disease management, provider operations, or health insurance experience

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

LICENSES AND CERTIFICATIONS

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

• Preferred: Oncology experience, certification in case management

SKILLS

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

OTHER DETAILS

• Travel: 0-25%
• Position: Office-based, with occasional training and site visits

Note: This description outlines primary duties and may not include all responsibilities. Compliance with all legal, ethical, and privacy standards is required.