Remote Oncology Case Manager RN – Complex Care Advocate

Highmark Health; Clayton (MO); Hybrid; USD 114,000 - 140,000; Full time

Job summary

Highmark Health in the United States seeks a Case Manager to deliver comprehensive case management services, assess needs, develop and coordinate care plans, and monitor progress toward optimal health outcomes. You will collaborate with physicians and care teams to ensure access to services while containing costs.

Responsibilities include documentation, HIPAA compliance, and mentoring junior Case Managers as part of a collaborative health care team focused on quality outcomes.

Qualifications

• 5 years in any combination of clinical, case/utilization management, and/or disease condition management experience, or provider operations and/or health insurance experience.
• Advanced training in CBT, motivational interviewing, or DBT.
• Proficiency with Microsoft suite and case management software.
• Experience with diverse populations.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess health status, needs and resources.
• Collaborate with members, physicians and providers to create individualized care plans.
• Coordinate care plans and ensure access to services and resources.
• Monitor progress and adjust plans as needed.
• Advocate for members to meet health care needs while containing costs.
• Collaborate with physicians and care teams to execute the plan of care.
• Ensure documentation complies with policies and HIPAA.

Skills

Clinical experience

Oncology

Transplant

Maternity

NICU

Pediatric

Diverse populations

CBT

Motivational interviewing

DBT

Clinical assessment

Care planning

MS Office

Case management software

EHR

Healthcare systems

Education

Bachelors in Nursing

Tools

Microsoft Office

Electronic Health Records (EHR)

Job description

Highmark Health in the United States seeks a Case Manager to deliver comprehensive case management services, assess needs, develop and coordinate care plans, and monitor progress toward optimal health outcomes. You will collaborate with physicians and care teams to ensure access to services while containing costs.

Responsibilities include documentation, HIPAA compliance, and mentoring junior Case Managers as part of a collaborative health care team focused on quality outcomes.