Complex Case Manager RN - Oncology (Remote)

Lensa; Richmond (VA); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Complex Case Manager RN specializing in oncology to oversee a diverse panel of members. This remote role emphasizes the development of personalized care plans, leveraging data and clinical judgment to enhance health outcomes. You'll collaborate with a multidisciplinary team, addressing barriers to care and ensuring compliance with regulatory standards. Ideal candidates will possess strong communication and organizational skills, alongside a commitment to patient-centered care. If you're ready to make a significant impact in healthcare, this opportunity is for you.

Qualifications

• 7+ years of clinical or case management experience required.
• RN license in PA, WV, DE, or NY required.

Responsibilities

• Assess health needs and create care plans for members.
• Collaborate with a multidisciplinary team for resource referrals.

Skills

Strong communication skills

Negotiation skills

Interpersonal skills

Knowledge of disease processes

Healthcare systems knowledge

Proficiency in MS Excel

Data analysis skills

Organizational skills

Time management skills

Ability to work independently

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 :

JOB SUMMARY

This role involves primary ownership of a specific panel of members with varying health statuses and clinical needs. The incumbent assesses health management needs, uses data and clinical judgment to identify appropriate interventions, and collaborates with a multidisciplinary team to refer members to necessary resources. Responsibilities include developing care plans, encouraging behavioral changes, addressing barriers, coordinating care, and monitoring quality outcomes for the panel.

ESSENTIAL RESPONSIBILITIES

1. Oversee members by assessing health needs, identifying interventions, and triaging to resources.
2. Create and implement care plans to meet members' needs and improve health outcomes.
3. Achieve targeted patient goals and document activities in compliance with standards.
4. Maintain knowledge of and adhere to relevant regulatory and practice standards.
5. 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, 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 (others to be obtained within 6 months).

Preferred: Oncology experience, Certification in Case Management.

SKILLS

• Strong communication, negotiation, and interpersonal skills.
• Knowledge of disease processes and healthcare systems.
• Proficiency in MS Excel and data analysis.
• Organizational and time management skills.
• Ability to work independently and in teams.

OTHER INFORMATION

Travel: 0-25%

Position Type: Office-Based

Physical Demands: Up to 10-50 pounds lifting rarely required.

Note: This description provides a general overview and may not include all duties or qualifications.