Senior Oncology Case Manager RN – Remote

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

Job summary

Highmark Health is seeking a licensed RN Case Manager to deliver comprehensive case management for members, coordinating care, ensuring quality outcomes, and containing costs under existing benefit contracts.

The role requires advanced clinical knowledge, experience in case/utilization management, and collaboration with physicians and care teams. You will develop and monitor care plans, advocate for members, and mentor junior case managers while adhering to HIPAA and policy standards.

Qualifications

• Current RN license in the state or multi-state via eNLC
• Experience in clinical or utilization/case management
• Experience serving diverse populations favored
• Advanced training in CBT, motivational interviewing, or DBT preferred

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Coordinate services and monitor progress toward goals.
• Collaborate with physicians and care teams to implement plans.
• Advocate for members and ensure documentation complies with policies.

Skills

Clinical knowledge and case management

Case/utilization management

CBT/Motivational interviewing/DBT

EHR and case management software

MS Office proficiency

Healthcare systems understanding

Education

Bachelor of Science in Nursing

Tools

Case management software

Electronic Health Records (EHR)

Job description

Highmark Health is seeking a licensed RN Case Manager to deliver comprehensive case management for members, coordinating care, ensuring quality outcomes, and containing costs under existing benefit contracts.

The role requires advanced clinical knowledge, experience in case/utilization management, and collaboration with physicians and care teams. You will develop and monitor care plans, advocate for members, and mentor junior case managers while adhering to HIPAA and policy standards.