Oncology Case Manager RN — Remote Care Coordination Leader

Highmark Health; Santa Fe (NM); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services, coordinating care plans and services to improve health outcomes while containing costs. The role involves advanced clinical assessments, collaboration with physicians, and ensuring adherence to policies and HIPAA.

The ideal candidate will have RN licensure, 5 years of relevant experience, and proficiency with EHR and case management software. Office-based or remote position with occasional travel.

Qualifications

• Minimum 5 years in clinical, case/utilization management, or disease condition management.
• RN licensure (state) or multi-state licensure via eNLC; CCM within 36 months.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop care plans.
• Coordinate services and monitor progress toward goals.
• Act as advocate and liaison to meet member health care needs.
• Collaborate with physicians and providers to implement plans.
• Ensure documentation complies with policies and HIPAA.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

EHR proficiency

Education

High School/GED

Bachelors 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, coordinating care plans and services to improve health outcomes while containing costs. The role involves advanced clinical assessments, collaboration with physicians, and ensuring adherence to policies and HIPAA.

The ideal candidate will have RN licensure, 5 years of relevant experience, and proficiency with EHR and case management software. Office-based or remote position with occasional travel.