Remote Oncology Case Manager RN | Lead Care Coordinator

Highmark Health; United States; Remote; USD 79.000 - 127.000; Vollzeit

Zusammenfassung

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management to members, coordinating care and monitoring outcomes to optimize health results. The role emphasizes cost-effective care and proper utilization of benefits while collaborating with physicians and the health team.

Responsibilities include assessments, care plan development, and mentorship for junior staff. Required experience includes 5 years in clinical or utilization management, with RN licensure and CCM

Qualifikationen

• 5 years in clinical, utilization management, or related health roles.
• RN licensure in state or multi-state via eNLC.
• Bachelor's degree in Nursing or higher preferred.

Aufgaben

• Manage a caseload of members with complex health needs.
• Develop and implement individualized care plans.
• Coordinate services with physicians and providers.
• Monitor progress and adjust plans as needed.
• Ensure documentation complies with HIPAA and policies.

Kenntnisse

Case management

Oncology experience

Leadership

Advocacy

Communication

Ausbildung

RN license

BSN preferred

Tools

Microsoft Office

EHR systems

Jobbeschreibung

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management to members, coordinating care and monitoring outcomes to optimize health results. The role emphasizes cost-effective care and proper utilization of benefits while collaborating with physicians and the health team.

Responsibilities include assessments, care plan development, and mentorship for junior staff. Required experience includes 5 years in clinical or utilization management, with RN licensure and CCM