Remote Oncology Case Manager RN | Advocate for Optimal Care

Highmark Health; Madison (WI); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services, coordinating care plans and resources to promote optimal health outcomes while containing costs.

The role requires state RN licensure (or eNLC) and CCM certification within 36 months of hire. You will collaborate with physicians, providers, and other health professionals to implement individualized care plans.

Qualifications

• 5 years in clinical, case/utilization management, and/or health insurance roles.
• RN licensure (state) or multi-state via eNLC.
• CCM certification must be obtained within 36 months of hire (exempts from Aug 2026).

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop individualized care plans in collaboration with members and providers.
• Coordinate services and monitor progress toward goals.
• Document activities in compliance with policies and regulations.
• 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 & mentoring

Negotiation & advocacy

Healthcare systems knowledge

Education

High School/GED

Bachelor's in Nursing

Tools

Microsoft Office

Case management software

Electronic Health Records (EHR)

Job description

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services, coordinating care plans and resources to promote optimal health outcomes while containing costs.

The role requires state RN licensure (or eNLC) and CCM certification within 36 months of hire. You will collaborate with physicians, providers, and other health professionals to implement individualized care plans.