Remote Oncology Case Manager RN - Complex Care Navigator

Highmark Health; Michigan; Remote; USD 114,000 - 140,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members, coordinating care plans and monitoring progress to promote optimal health outcomes.

Responsibilities include managing a caseload of complex cases, collaborating with physicians and providers, and ensuring adherence to HIPAA and company policies while supporting cost containment and quality care.

Qualifications

• 5 years in clinical, case/utilization management, or related health care roles.
• Experience with diverse populations.
• Advanced training in CBT, motivational interviewing, or DBT.
• Proficiency with MS Office, case management software, and electronic health records.
• Bachelor in Nursing is required.

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop and implement individualized care plans.
• Coordinate services and monitor progress toward goals.
• Advocate for members and liaise with physicians and providers.
• Ensure documentation complies with policies and HIPAA.
• Provide guidance to junior Case Managers.
• Support cost containment while ensuring quality care.

Education

Bachelor's in Nursing

Tools

Microsoft Office

EHR systems

Case management software

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members, coordinating care plans and monitoring progress to promote optimal health outcomes.

Responsibilities include managing a caseload of complex cases, collaborating with physicians and providers, and ensuring adherence to HIPAA and company policies while supporting cost containment and quality care.