Oncology Case Manager RN - Care Coord & Advocacy

Highmark Health; Topeka (KS); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services aimed at quality, cost-effective care delivery for members.

The role involves assessing needs, developing and coordinating care plans, and monitoring outcomes while containing health care costs. It requires collaboration with physicians and the health care team, documentation compliance, and mentorship to junior staff.

Qualifications

• Minimum 5 years in clinical, case/utilization management, or related health-care roles.
• Preferred experience with diverse populations and culture competency.
• CCM certification must be obtained within 36 months of hire; incumbents as of Aug 2026 are exempt.

Responsibilities

• Manage a caseload of members with complex health needs and advanced clinical knowledge.
• Conduct comprehensive assessments and develop complex care plans.
• Assess health status, needs, and available resources.
• Coordinate and implement care plans with physicians and providers.
• Monitor progress and adjust plans to achieve goals.
• Advocate for members and ensure cost-effective care within benefits.
• Document activities in compliance with policies and regulations.

Skills

Clinical assessment

Care planning

Leadership

Negotiation

EHR proficiency

Education

High School/GED

Bachelor's in Nursing

Tools

Microsoft Office

Case management software

Electronic Health Records (EHR)

Job description

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services aimed at quality, cost-effective care delivery for members.

The role involves assessing needs, developing and coordinating care plans, and monitoring outcomes while containing health care costs. It requires collaboration with physicians and the health care team, documentation compliance, and mentorship to junior staff.