Complex Case Manager RN - Oncology (Remote)

Lensa; Saint Paul (MN); Remote; USD 57,000 - 108,000; Full time

Job summary

An innovative 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 management needs, and coordinating care to improve health outcomes. You will develop personalized care plans, encourage behavioral changes, and ensure compliance with regulatory standards. Ideal candidates will have extensive experience in clinical settings, strong communication skills, and a commitment to enhancing patient care. Join a forward-thinking team dedicated to making a significant impact in the lives of patients dealing with complex health issues.

Qualifications

• 7+ years in clinical or case management fields required.
• Oncology experience and Case Management certification preferred.

Responsibilities

• Manage a panel of members, assessing needs and identifying interventions.
• Create and manage care plans to achieve targeted patient outcomes.
• Stay updated on regulatory and practice standards.

Skills

Strong communication skills

Negotiation skills

Interpersonal skills

Knowledge of disease processes

Healthcare costs knowledge

Proficiency in MS Excel

Data analysis

Organizational abilities

Multitasking abilities

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

ESSENTIAL RESPONSIBILITIES

• Oversee a panel of members, assessing needs and identifying interventions or referrals.
• Create and manage care plans with goals and re-assessment schedules.
• Achieve targeted patient outcomes and document activities in compliance with standards.
• Stay updated on regulatory and practice standards (CMS, CMSA, ACMA).
• 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, or related fields.

Preferred:

• Experience with cognitive behavioral therapy, motivational interviewing, or dialectical behavior therapy.
• Experience working with diverse populations and understanding cultural competency.

Licenses and Certifications

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

Preferred:

• Oncology experience, Case Management certification.

Skills

• Strong communication, negotiation, and interpersonal skills.
• Knowledge of disease processes and healthcare costs.
• Proficiency in MS Excel and data analysis.
• Organizational and multitasking abilities.

Additional Information

Position is office-based with minimal travel (0-25%). Physical demands are light. The role adheres to all legal, ethical, and privacy standards, including HIPAA.

Salary range: $57,700 - $107,800, based on experience and location.