Registered Nurse, Case Manager - Oncology or Specialty Pharmacy Experience Required

The Muse; Boise (ID); Remote; USD 54,000 - 143,000; Full time

Job summary

A leading healthcare company is seeking a Registered Nurse, Case Manager with Oncology or Specialty Pharmacy experience for a remote telephonic role. This position requires significant clinical experience, active RN license, and involvement in case management with an attractive compensation package and comprehensive benefits.

Benefits

Medical benefits

401(k)

Stock purchase plan

Wellness programs

Paid time off

Flexible schedules

Qualifications

• 5+ years' RN experience with at least 1 year in a hospital setting.
• Active RN license in state of residence, willingness for multi-state license.
• 1+ years' experience in Oncology or Specialty Pharmacy.

Responsibilities

• Applying clinical guidelines and care management plans for patient assessment.
• Collaborating with teams to overcome barriers and meet patient care goals.
• Performing comprehensive assessments considering co-morbidities.

Skills

Clinical judgment

Motivational interviewing

Telephonic case management

Education

Diploma or Associate Degree in Nursing

BSN preferred

Tools

Electronic documentation

Job description

Registered Nurse, Case Manager - Oncology or Specialty Pharmacy Experience Required

Join to apply for the Registered Nurse, Case Manager - Oncology or Specialty Pharmacy Experience Required role at The Muse.

This is a remote work-from-home role anywhere in the US with virtual training. Shift schedule is 8:30am - 5:00pm within the time zone of residence.

American Health Holding, Inc (AHH), a division within Aetna/CVS Health, is seeking experienced Registered Nurses for telephonic case management, working with patients and care teams for fully and/or self-insured clients.

Responsibilities include:

• Applying clinical guidelines, care management plans, and regulatory standards to assess benefits and member needs.
• Using clinical judgment to develop strategies to reduce risk factors and address health/social indicators.
• Performing comprehensive assessments considering co-morbidities and diagnoses.
• Collaborating with supervisors and multidisciplinary teams to overcome barriers and meet goals.
• Utilizing motivational interviewing to engage members and discern their health needs.
• Escalating member needs appropriately and actively reaching out to guide their care.
• Performing medical necessity reviews.

Qualifications:

• 5+ years' RN experience with at least 1 year in a hospital setting.
• Active, unrestricted RN license in the state of residence, with multi-state/compact license willingness.
• 1+ years' experience in Oncology or Specialty Pharmacy.
• Experience with electronic documentation.

Preferred Qualifications:

• Case management, discharge planning, nurse navigator, or care coordinator experience.
• Utilization Review experience.
• URAC accreditation, familiarity with MCG, NCCN, Lexicomp, bilingual in Spanish preferred.

Education:

• Diploma or Associate Degree in Nursing required; BSN preferred.

Compensation ranges from $54,095 to $142,576 annually, with benefits including medical, 401(k), stock purchase plan, wellness programs, paid time off, flexible schedules, and more.

Application deadline is 06/30/2025. Qualified applicants with arrest or conviction records will be considered per applicable laws.

Additional Details:

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Healthcare Provider