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

The Muse; Carson City (NV); Remote; USD 54,000 - 143,000; Full time

Job summary

A leading healthcare provider is seeking a Registered Nurse, Case Manager specializing in Oncology or Specialty Pharmacy. This full-time remote position involves comprehensive case management, clinical assessments, and collaboration with care teams to enhance patient outcomes. The role offers a competitive salary and benefits, emphasizing professional development and flexible work arrangements.

Benefits

Medical benefits

401(k)

Stock purchase program

Wellness programs

Paid time off

Flexible schedules

Qualifications

• 5+ years' experience as an RN, with at least 1 year in a hospital setting.
• Active RN license in the state of residence.
• 1+ years' experience in Oncology or Specialty Pharmacy.

Responsibilities

• Applying clinical guidelines and care management plans.
• Conducting assessments from various sources.
• Collaborating with clinical teams to overcome barriers and meet care goals.

Skills

Clinical judgment

Motivational interviewing

Care coordination

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 a medical management company founded in 1993. It is URAC accredited in Case Management, Disease Management, and Utilization Management. The position involves working as a telephonic case manager with patients and their care teams for fully and/or self-insured clients.

Responsibilities include:

• Applying clinical guidelines, care management plans, policies, and regulatory standards while assessing benefits and members' needs.
• Using clinical judgment to develop strategies to reduce risk factors and address health and social indicators affecting care.
• Conducting assessments from various sources to address conditions including co-morbidities and diagnoses impacting functionality.
• Consulting with supervisors and colleagues, presenting cases at conferences for multidisciplinary review.
• Collaborating with clinical teams to overcome barriers and meet care goals.
• Following regulatory and company policies in case management processes.
• Using motivational interviewing to engage members and assess their health needs.
• Identifying and escalating member needs according to guidelines.
• Reaching out actively to members to guide their care and performing medical necessity reviews.

Qualifications:

• 5+ years' experience as a Registered Nurse (RN), with at least 1 year in a hospital setting.
• Active, unrestricted RN license in the state of residence, willing to obtain multi-state/compact privileges.
• 1+ years' experience in Oncology or Specialty Pharmacy.
• Experience with electronic documentation.

Preferred Qualifications:

• 1+ years' experience in Case Management, discharge planning, nurse navigation, or nurse care coordination.
• Experience with Utilization Review, URAC accreditation, MCG, NCCN, or Lexicomp.
• Bilingual in Spanish is preferred.

Education:

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

Additional details:

• Full-time, 40 hours/week.
• Pay range: $54,095 - $142,576, depending on experience and location.
• Benefits include medical, 401(k), stock purchase, wellness programs, paid time off, flexible schedules, and more.

Application window closes on 06/30/2025. Qualified applicants with arrest or conviction records will be considered in accordance with laws.