Oncology Case Manager RN: Remote Care Leader

Highmark Health; Boise (ID); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive care coordination for members. You will assess needs, develop and implement care plans, and monitor progress to ensure quality, cost-effective outcomes.

The role requires an active RN license, 5 years of related experience, and CCM certification within 36 months of hire unless exempt. You will collaborate with physicians and providers and support junior staff while maintaining HIPAA compliance.

Qualifications

• Must hold current RN license (state or multi-state via eNLC).
• CCM certification must be obtained within 36 months of hire (exempt for incumbents as of Aug 2026).
• Minimum 5 years in clinical, case/utilization management, disease management, or health insurance operations.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess members' health status, needs and resources.
• Develop individualized care plans with members and providers.
• Coordinate care plans and ensure access to services.
• Monitor progress and adjust plans as needed.
• Document activities in compliance with policies and HIPAA.
• Mentor and provide guidance to lower-level Case Managers.
• Collaborate with physicians and other providers to carry out the plan.

Skills

Clinical assessment

Care planning

Leadership & mentoring

Advocacy

Communication

EHR proficiency

Healthcare systems knowledge

Negotiation

Education

High School/GED

Bachelor's in Nursing (preferred)

Tools

Microsoft Office

Case Management Software

Electronic Health Records

Job description

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive care coordination for members. You will assess needs, develop and implement care plans, and monitor progress to ensure quality, cost-effective outcomes.

The role requires an active RN license, 5 years of related experience, and CCM certification within 36 months of hire unless exempt. You will collaborate with physicians and providers and support junior staff while maintaining HIPAA compliance.