Oncology RN Case Manager — Remote Care Coordination

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

Job summary

Highmark Health is seeking a Case Manager to deliver comprehensive case management services for members with complex health needs. You will assess health status, develop and coordinate care plans, and monitor progress while ensuring cost-effective care aligned with benefits and policies.

The role requires an RN license (state or eNLC), 5 years of related experience, and CCM certification within 36 months. Preference given to candidates with specialty experience and cultural competency.

Qualifications

• Minimum 5 years in clinical, utilization/case management or related roles.
• RN licensure (state) or multi-state via eNLC; CCM certification within 36 months of hire.
• Preferred: specialty clinical experience and cultural competency in diverse populations.

Responsibilities

• Manage a caseload of members with complex health needs and advanced clinical care.
• Conduct assessments and develop individualized care plans with providers.
• Coordinate services and monitor progress toward goals.
• Advocate for members and ensure cost-effective care within benefits.
• Document activities per policy and ensure regulatory compliance.
• Provide guidance to junior Case Managers and share clinical expertise.

Skills

Clinical assessment

Care planning

Leadership

Mentoring

Negotiation

Advocacy

Microsoft Office

EHR systems

Healthcare systems

Education

High School/GED

Bachelor's in Nursing

Tools

Case management software

Job description

Highmark Health is seeking a Case Manager to deliver comprehensive case management services for members with complex health needs. You will assess health status, develop and coordinate care plans, and monitor progress while ensuring cost-effective care aligned with benefits and policies.

The role requires an RN license (state or eNLC), 5 years of related experience, and CCM certification within 36 months. Preference given to candidates with specialty experience and cultural competency.