Senior Oncology Case Manager RN – Remote Care Navigator

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

Job summary

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, develop care plans, and coordinate services to promote quality, cost-effective outcomes for members. This role emphasizes advanced clinical assessment, advocacy, and collaboration with physicians and the health care team.

The position requires RN licensure (or multi-state eNLC) and CCM certification within 36 months of hire, with potential remote work and up to 25% travel.

Qualifications

• 5 years in clinical, case/utilization management, or health insurance roles.
• CCM certification must be obtained within 36 months of hire (exemption for Aug 2026 hires).
• Current RN licensure in state or multi-state eNLC licensure.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop care plans.
• Assess health status, needs, and resources; coordinate services.
• Implement and monitor care plans; adjust as needed to meet goals.
• Advocate for members and collaborate with providers and team.
• Document activities per policies and HIPAA requirements.
• Provide guidance to lower-level Case Managers.

Skills

Clinical assessment

Care planning

Leadership & mentoring

Negotiation & advocacy

EHR / software proficiency

Education

High School / GED

Bachelors in Nursing

Tools

Microsoft Office

Case Management Software

Electronic Health Records

Job description

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, develop care plans, and coordinate services to promote quality, cost-effective outcomes for members. This role emphasizes advanced clinical assessment, advocacy, and collaboration with physicians and the health care team.

The position requires RN licensure (or multi-state eNLC) and CCM certification within 36 months of hire, with potential remote work and up to 25% travel.