Senior Oncology Case Manager RN – Care & Cost Optimization

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

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management to members, coordinating care plans, and monitoring outcomes to promote quality and cost-effective care. The role involves collaboration with physicians, providers, and other health team members while ensuring regulatory compliance and documentation.

The candidate should have 5+ years in clinical or utilization management, RN licensure, CCM certification within 36 months, and strong knowledge of case management

Qualifications

• Must have 5 years of clinical/case management experience or health insurance/provider operations background.
• Experience with diverse populations and complex health needs.
• Advanced CBT, motivational interviewing, or DBT training and experience.

Responsibilities

• Manage caseloads of members with complex health needs and develop care plans.
• Coordinate services and monitor progress toward goals.
• Advise and mentor lower-level Case Managers and collaborate with physicians and healthcare teams.

Skills

CBT

Motivational Interviewing

DBT

Clinical assessment

Care planning

Microsoft Office

EHR

Education

Bachelors in Nursing

Tools

Case management software

Electronic Health Records (EHR)

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management to members, coordinating care plans, and monitoring outcomes to promote quality and cost-effective care. The role involves collaboration with physicians, providers, and other health team members while ensuring regulatory compliance and documentation.

The candidate should have 5+ years in clinical or utilization management, RN licensure, CCM certification within 36 months, and strong knowledge of case management