Senior Oncology Case Manager RN - Remote Care Coordination

Highmark Health; Alabama; À distance; USD 114 000 - 140 000; Plein temps

Résumé du poste

Highmark Health is seeking a qualified Case Manager to deliver comprehensive case management services to members, focusing on quality, cost-effective care and optimal health outcomes. You will assess needs, develop and implement care plans, coordinate services, and monitor progress while containing costs.

The role requires advanced clinical knowledge, strong collaboration with care teams, and adherence to HIPAA and company policies.

Qualifications

• 5 years in clinical/case/utilization management or related health operations experience.
• Experience with diverse populations and care settings.
• Advanced training in CBT, motivational interviewing, or DBT.
• Expertise in clinical assessment and care planning.
• RN licensure in good standing and/or multi-state licensure.

Responsabilités

• Manage a caseload of members with complex health needs and advanced clinical requirements.
• Conduct comprehensive assessments and develop complex care plans.
• Assess health status, needs, and available resources for members.
• Coordinate services and monitor progress toward care goals.
• Advocate for members and coordinate with physicians and providers.
• Document all activities per policies and regulatory standards.

Connaissances

Clinical knowledge

Care management

CBT/DBT training

Interpersonal communication

Nursing background

Formation

Bachelors in Nursing

Outils

Microsoft Office Suite

Case management software

Electronic Health Records

Description du poste

Highmark Health is seeking a qualified Case Manager to deliver comprehensive case management services to members, focusing on quality, cost-effective care and optimal health outcomes. You will assess needs, develop and implement care plans, coordinate services, and monitor progress while containing costs.

The role requires advanced clinical knowledge, strong collaboration with care teams, and adherence to HIPAA and company policies.