Remote Oncology RN Case Manager — Care Coordinator

Highmark Health; Northern (KY); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive services, assess needs, and coordinate plans to promote quality, cost-effective care for members.

The role requires 5 years in clinical/utilization management, current RN licensure or eNLC, and CCM within 36 months. Oncology experience and CBT/DBT training are preferred; strong EHR/case management software skills are essential.

Qualifications

• 5 years in clinical, case/utilization management, or related health insurance experience.
• RN licensure (state) or multi-state licensure through eNLC; CCM certification within 36 months.
• Preferred oncology specialty experience and CBT/DBT training.

Responsibilities

• Manage a caseload of members with complex health needs and develop care plans.
• Assess health status, needs, and resources; coordinate services and monitor progress.
• Collaborate with physicians and the health care team to implement plans.
• Document activities in compliance with policies and accreditation standards.
• Provide guidance and mentorship to lower-level Case Managers.

Skills

Oncology assessment

Care planning

Leadership

Negotiation

Advocacy

EHR proficiency

Microsoft Office

Healthcare systems knowledge

Education

High School/GED

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 services, assess needs, and coordinate plans to promote quality, cost-effective care for members.

The role requires 5 years in clinical/utilization management, current RN licensure or eNLC, and CCM within 36 months. Oncology experience and CBT/DBT training are preferred; strong EHR/case management software skills are essential.