Senior Oncology Case Manager RN — Remote

Highmark Health; Alaska; Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Health is seeking a Case Manager to deliver comprehensive case management services to members, assess needs, develop care plans, coordinate services, and monitor progress to promote quality, cost-effective care and positive health outcomes. This role requires collaboration with physicians and providers, adherence to HIPAA and policies, and mentorship of junior Case Managers.

A current RN licensure is required, with CCM certification to be obtained within 36 months of hire (exemption

Qualifications

• 5 years in clinical, case/utilization management or related roles.
• RN license (state) or multi-state via eNLC.
• CCM certification to be obtained within 36 months of hire; exemption noted for Aug 2026.

Responsibilities

• Manage a caseload of members with complex health needs and advanced clinical knowledge.
• Develop and implement individualized care plans with members, physicians, and providers.
• Coordinate services, monitor progress toward goals, and adjust plans as needed.
• Advocate for members and ensure cost-effective care within contract benefits.
• Document activities in compliance with HIPAA and company policies; mentor junior staff.

Skills

Clinical assessment & care planning

Leadership & mentoring

Negotiation & advocacy

MS Office / EHR proficiency

Healthcare systems knowledge

Education

High School/GED

Bachelor's in Nursing

Job description

Highmark Health is seeking a Case Manager to deliver comprehensive case management services to members, assess needs, develop care plans, coordinate services, and monitor progress to promote quality, cost-effective care and positive health outcomes. This role requires collaboration with physicians and providers, adherence to HIPAA and policies, and mentorship of junior Case Managers.

A current RN licensure is required, with CCM certification to be obtained within 36 months of hire (exemption