Remote Oncology RN Case Manager – Care Coordinator

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

Job summary

Highmark Health seeks an experienced Case Manager to provide comprehensive case management services, coordinating care and monitoring outcomes while containing costs. The role requires advanced clinical knowledge, collaboration with physicians and providers, and ongoing assessment of member needs within contract benefits.

The incumbent will advocate for patients, ensure documentation accuracy, and mentor junior team members. Strong EHR and case management software proficiency are essential.

Qualifications

• 5 years in clinical, case/utilization management, or disease condition management experience.
• Oncology, Transplant, Maternity, NICU, Pediatric experience.
• Experience working with diverse populations' healthcare needs.
• Advanced training in CBT, motivational interviewing, or DBT.
• Expertise in clinical assessment and care planning.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess members' health status, needs, and resources.
• Develop individualized care plans with members and providers.
• Coordinate and implement care plans with access to services.
• Monitor progress toward goals and adjust plans as needed.
• Advocate and liaison to meet health care needs within contract benefits.
• Collaborate with physicians and care team to carry out plans.
• Document activities in line with policies and regulations.
• Provide guidance to lower-level Case Managers.

Skills

Clinical case management

CBT

Motivational interviewing

DBT

Healthcare systems

Education

Bachelor's in Nursing

RN licensure

Tools

Microsoft Office

Case management software

Electronic Health Records

Job description

Highmark Health seeks an experienced Case Manager to provide comprehensive case management services, coordinating care and monitoring outcomes while containing costs. The role requires advanced clinical knowledge, collaboration with physicians and providers, and ongoing assessment of member needs within contract benefits.

The incumbent will advocate for patients, ensure documentation accuracy, and mentor junior team members. Strong EHR and case management software proficiency are essential.