Remote Oncology Case Manager RN

Highmark Health; Oklahoma City (OK); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services, assess member needs, develop and coordinate complex care plans, and monitor progress while containing costs. You will collaborate with physicians, providers, and the care team to deliver quality outcomes.

The role requires advanced clinical knowledge, leadership, and advocacy skills, with emphasis on compliant documentation and HIPAA standards. Office-based or remote work options may be available.

Qualifications

• Requires 5 years in clinical/case management or related health insurance experience.
• Specialty specific clinical experience (e.g., Oncology, Transplant, Maternity, NICU, Pediatric)
• Experience working with the healthcare needs of diverse populations
• Experience demonstrating understanding of culture competency in addressing targeted populations
• Advanced training and experience in CBT, motivational interviewing, or DBT

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess members' health status, needs, and resources.
• Develop individualized care plans with members, physicians, and providers.
• Coordinate care plans to ensure access to services and resources.
• Monitor progress toward goals and adjust plans as needed.
• Act as advocate and liaison to meet members' health care needs.
• Collaborate with physicians, providers, and care team; document activities per policy.
• Provide guidance and mentorship to lower-level Case Managers.
• Serve as a resource for clinical expertise and problem-solving.

Skills

Clinical assessment

Care planning

Leadership

Negotiation

Advocacy

EHR

Microsoft Office

Healthcare systems

Education

High School / GED

Bachelor's in Nursing

Tools

Case management software

Electronic Health Records

Job description

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services, assess member needs, develop and coordinate complex care plans, and monitor progress while containing costs. You will collaborate with physicians, providers, and the care team to deliver quality outcomes.

The role requires advanced clinical knowledge, leadership, and advocacy skills, with emphasis on compliant documentation and HIPAA standards. Office-based or remote work options may be available.