Remote Oncology Nurse Case Manager – Senior

Highmark Health; New Jersey; Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management services to members, focusing on quality, cost-effective care and optimal health outcomes in New Jersey. You will assess needs, develop and implement care plans, coordinate services, and monitor progress while containing costs.

Requirements include 5 years of relevant experience, RN licensure (or multi-state eNLC), and CCM certification within 36 months. Office-based or remote position with occasional travel.

Qualifications

• 5+ years in clinical, case/utilization management, disease condition management, or health insurance operations.
• RN licensure or multi-state license (eNLC) requirement.
• CCM certification must be obtained within 36 months of hire (exemption for current holders as of Aug 2026).
• Bachelor's in Nursing preferred.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess health status, needs and resources of members.
• Develop individualized care plans with members and providers.
• Coordinate and implement care plans to access services.
• Monitor progress and adjust plans as needed.
• Advocate and liaise to meet member health care needs.
• Document activities in compliance with policies and regulations.

Skills

Clinical assessment

Care planning

Advocacy

Communication

Leadership

Education

RN licensure

Bachelor's in Nursing

Tools

Case management software

Electronic Health Records

Microsoft Office

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management services to members, focusing on quality, cost-effective care and optimal health outcomes in New Jersey. You will assess needs, develop and implement care plans, coordinate services, and monitor progress while containing costs.

Requirements include 5 years of relevant experience, RN licensure (or multi-state eNLC), and CCM certification within 36 months. Office-based or remote position with occasional travel.