Oncology Case Manager RN — Remote Care Leader

Highmark Health; Lansing (MI); À distance; USD 79 000 - 127 000; Plein temps

Résumé du poste

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, coordinating care plans and ensuring quality, cost-effective outcomes for members.

The role requires 5 years of clinical or case management experience, active RN licensure or multi-state eNLC, and CCM certification within 36 months of hire. Collaboration with physicians and healthcare teams is essential.

Qualifications

• 5 years in clinical, case/utilization management, or disease condition management experience.
• Current State RN licensure or multi-state licensure through eNLC.
• Certified Case Manager (CCM) certification must be obtained within 36 months of hire.

Responsabilités

• 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.
• Monitor member progress toward goals and adjust care plans as needed.
• Evaluate the effectiveness of interventions and services.
• Act as an advocate and liaison to meet a member's individual health care needs by assessing, planning, implementing, coordinating, monitoring and evaluating options and services.
• Work collaboratively and communicate clearly with physicians, providers, co-workers and other members of the health care team to carry out the established plan of care.
• Ensure all activities are documented and conducted in compliance with applicable policies and requirements.
• Provide guidance and mentorship to lower-level Case Managers.
• Serve as a resource for clinical expertise and problem-solving.
• Other duties as assigned or requested.

Formation

High School/GED

Bachelors in Nursing

Description du poste

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, coordinating care plans and ensuring quality, cost-effective outcomes for members.

The role requires 5 years of clinical or case management experience, active RN licensure or multi-state eNLC, and CCM certification within 36 months of hire. Collaboration with physicians and healthcare teams is essential.