Complex Case Manager RN - Oncology (Remote)

Lensa; Providence (RI); Remote; USD 57,000 - 108,000; Full time

Job summary

A leading healthcare organization is seeking a Complex Case Manager RN specializing in Oncology. This remote role involves managing a diverse panel of members, assessing their health needs, and coordinating care to improve clinical outcomes. The ideal candidate will have extensive experience in clinical settings and possess strong communication and organizational skills. Join a team dedicated to enhancing patient care and outcomes.

Qualifications

• 7 years in clinical, case management, disease management, or related fields required.

Responsibilities

• Oversee a panel of members and assess their needs.
• Create and implement care plans and document activities.
• Achieve targeted patient outcomes and comply with standards.

Skills

Communication

Negotiation

Interpersonal Skills

Data Analysis

Organizational Skills

Multitasking

Education

High School Diploma/GED

Tools

MS Excel

Job description

Complex Case Manager RN - Oncology (Remote)

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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 analytics alongside clinical judgment to identify appropriate interventions, and refers members to multidisciplinary 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, assess their needs, and identify suitable clinical interventions or resources.
• Create and implement care plans with goals and scheduled re-assessments.
• Achieve targeted patient outcomes and document all activities in compliance with standards and regulations.
• Stay current with applicable regulations and standards of practice.
• Perform other duties as assigned.

Education:

• Required: High School Diploma/GED

Experience:

• Required: 7 years in clinical, case management, disease management, or related fields.

Licenses and Certifications:

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

Skills:

• Excellent communication, negotiation, and interpersonal skills.
• Broad knowledge of disease processes and healthcare systems.
• Proficiency in MS Excel and data analysis.
• Strong organizational and multitasking abilities.

Additional Information:

Position is office-based with travel up to 25%. Physical demands are minimal. The role adheres to legal and ethical standards, including HIPAA compliance. Salary range: $57,700 - $107,800.