Oncology RN Case Manager: Senior Care Coordinator

Highmark Health; Trenton (NJ); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services, assess member needs, develop care plans, coordinate services, and monitor progress to promote quality outcomes while containing costs.

The role requires extensive clinical knowledge, strong leadership, and collaboration with physicians and healthcare teams. It supports office-based or remote work with travel limited to less than 25%.

Qualifications

• 5 years in clinical, case/utilization management, or disease condition management, or related health insurance operations.
• RN licensure in state or multi-state licensure (eNLC)
• CCM certification to be obtained within 36 months of hire (exempt for Aug 2026 hires)
• Experience serving diverse populations and cultural competency
• CBT/MI/DBT training or exposure is a plus

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct assessments and develop complex care plans.
• Assess health status, needs, and resources.
• Coordinate care plans with physicians and providers.
• Monitor progress and adjust plans as needed.
• Advocate for members and ensure cost-effective care.
• Document activities per policy and compliance standards.
• Mentor lower-level Case Managers.

Skills

Clinical assessment

Care planning

Leadership & mentoring

Negotiation & advocacy

Healthcare systems knowledge

Education

High School/GED

Bachelor of Nursing (preferred)

Tools

Microsoft Office

Case management software

Electronic Health Records (EHR)

Job description

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services, assess member needs, develop care plans, coordinate services, and monitor progress to promote quality outcomes while containing costs.

The role requires extensive clinical knowledge, strong leadership, and collaboration with physicians and healthcare teams. It supports office-based or remote work with travel limited to less than 25%.