Remote Oncology Case Manager RN — Senior Care Navigator

Highmark Health; Maryland; Remote; USD 114.000 - 140.000; Vollzeit

Zusammenfassung

Highmark Health is looking for 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. The role requires collaboration with physicians and the health care team and careful documentation in EHRs to ensure quality care.

The position involves HIPAA compliance, coaching for junior staff, and ongoing professional development.

Qualifikationen

• 5 years in clinical, case/utilization management or health insurance.
• Experience with diverse populations.
• Advanced training in CBT, motivational interviewing, or DBT.
• Proficiency with Microsoft Office and case management software.
• Strong understanding of healthcare systems and management principles.

Aufgaben

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop care plans.
• Assess health status, needs and resources.
• Coordinate care plans with members, physicians and providers.
• Implement and monitor care plans, ensuring access to services.
• Monitor progress and adjust plans as needed.
• Advocate and liaise to meet members' health needs using available resources.
• Collaborate with physicians and the health care team to execute the plan.
• Document activities in compliance with policies and HIPAA.
• Provide guidance and mentorship to junior Case Managers.
• Serve as a resource for clinical expertise and problem solving.

Kenntnisse

Clinical assessment

Care planning

Communication

Multidisciplinary collaboration

EHR proficiency

CBT/Motivational interviewing/DBT

Ausbildung

Bachelor of Science in Nursing

Tools

Case management software

Electronic health records

Microsoft Office

Jobbeschreibung

Highmark Health is looking for 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. The role requires collaboration with physicians and the health care team and careful documentation in EHRs to ensure quality care.

The position involves HIPAA compliance, coaching for junior staff, and ongoing professional development.