Oncology Case Manager RN: Lead Care & Advocacy (Remote)

Highmark Health; Accident (AR); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Health is seeking a skilled Case Manager to provide comprehensive case management services, focusing on quality, cost-effective care and optimal health outcomes for members. You will assess needs, coordinate services, create and monitor care plans, and advocate for members within contract benefits.

Responsibilities include managing complex caseloads, collaborating with physicians and providers, and ensuring documentation complies with HIPAA, policy, and accreditation standards.

Qualifications

• 5 years in any combination of clinical, case/utilization management, and/or disease condition management experience, or provider operations and/or health insurance experience.
• RN licensure current or eligible with enhanced NLC licensure.
• CCM certification must be obtained within 36 months of hire (exemption for August 2026)

Responsibilities

• Manage a caseload of members with complex health needs, requiring advanced clinical knowledge.
• Conduct comprehensive assessments and develop complex care plans.
• Assess members’ health status, needs, and available resources.
• Develop individualized care plans in collaboration with members, physicians, and other healthcare providers.
• Implement and coordinate care plans, ensuring access to appropriate services and resources.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

EHR proficiency

Education

High School/GED

Bachelor's in Nursing

Tools

Microsoft Office

Case management software

Electronic Health Records

Job description

Highmark Health is seeking a skilled Case Manager to provide comprehensive case management services, focusing on quality, cost-effective care and optimal health outcomes for members. You will assess needs, coordinate services, create and monitor care plans, and advocate for members within contract benefits.

Responsibilities include managing complex caseloads, collaborating with physicians and providers, and ensuring documentation complies with HIPAA, policy, and accreditation standards.