Remote Oncology Case Manager RN — Care Coordination Leader

Highmark Health; East Honolulu (HI); Remote; USD 120,000 - 135,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management services to members, assess needs, develop and implement care plans, coordinate services, and monitor progress while containing costs. This role requires advanced clinical knowledge and collaboration with physicians and the health care team.

Qualifications include 5 years in clinical or utilization management, RN licensure, CCM certification within 36 months, CBT/DBT experience, and proficiency with EHR and case

Qualifications

• 5 years in clinical, case/utilization management, and/or disease condition management experience.
• Oncology, Transplant, Maternity, NICU, Pediatric experience.
• Experience working with diverse populations.
• Advanced training in CBT, motivational interviewing, or DBT.
• Expertise in clinical assessment and care planning.
• Proficiency with Microsoft Office, case management software and EHRs.
• Strong understanding of healthcare systems and case management principles.
• Bachelors in Nursing.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess members’ health status, needs, and available resources.
• Develop individualized care plans in collaboration with members, physicians, and other healthcare providers.
• Implement and coordinate care plans, ensuring access to appropriate services and resources.
• Monitor member progress toward goals and adjust care plans as needed.
• Advocate and liaise to meet a member's health care needs by assessing, planning, implementing, coordinating, monitoring and evaluating options and services.
• Work collaboratively with physicians, providers, co-workers and other members of the health care team to carry out the plan of care.
• Ensure all activities are documented and conducted in compliance with policies and standards.
• Provide guidance and mentorship to lower-level Case Managers.
• Serve as a resource for clinical expertise and problem-solving.

Skills

Clinical assessment

Care planning

CBT

Motivational interviewing

DBT

MS Office

Education

Bachelor of Science in Nursing

Tools

Electronic Health Records

Case management software

Microsoft Office

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management services to members, assess needs, develop and implement care plans, coordinate services, and monitor progress while containing costs. This role requires advanced clinical knowledge and collaboration with physicians and the health care team.

Qualifications include 5 years in clinical or utilization management, RN licensure, CCM certification within 36 months, CBT/DBT experience, and proficiency with EHR and case