Senior Oncology Case Manager RN - Remote

Highmark Health; South Dakota Park (SD); Remote; USD 114,000 - 140,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members with complex health needs. You will assess, plan, implement, coordinate, monitor, and evaluate care, while ensuring cost-effective delivery and adherence to contract benefits.

The role requires collaboration with physicians and the health care team, documentation in EHRs, and ongoing professional development. Strong clinical background and RN licensure preferred.

Qualifications

• 5 years in clinical, case/utilization management, or health insurance.
• Experience with diverse populations and complex needs.
• Advanced training in CBT, motivational interviewing or DBT.
• Expertise in clinical assessment and care planning.
• Bachelor's in Nursing and RN licensure.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess health status, needs and resources.
• Develop individualized care plans with members and providers.
• Coordinate services and ensure access to resources.
• Monitor progress and adjust plans as needed.
• Advocate and liaise to meet health care needs and promote value.
• Collaborate with physicians, providers, and health care team.
• Document activities in compliance with policies and HIPAA.
• Provide guidance to lower-level Case Managers.

Skills

Clinical assessment

Care planning

Care coordination

EHR proficiency

Microsoft Office

CBT/MI/DBT training

Healthcare systems knowledge

Team collaboration

Education

Bachelor's in Nursing

Tools

Microsoft Office

Case management software

Electronic health records

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members with complex health needs. You will assess, plan, implement, coordinate, monitor, and evaluate care, while ensuring cost-effective delivery and adherence to contract benefits.

The role requires collaboration with physicians and the health care team, documentation in EHRs, and ongoing professional development. Strong clinical background and RN licensure preferred.