Senior Oncology RN Case Manager (Remote)

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

Job summary

Highmark Health is seeking an experienced Case Manager to provide comprehensive case management services, assess member needs, and develop care plans that promote quality and cost-effective care delivery. The role involves coordinating services and monitoring progress while containing healthcare costs.

You will advocate for members, work with physicians and providers, document activities per HIPAA and policy standards, and mentor junior Case Managers in a dynamic health system setting.

Qualifications

• High School/GED required.
• Bachelor's degree in Nursing preferred.
• Current State RN licensure or multi-state eNLC license required.
• CCM certification must be obtained within 36 months of hire; incumbents as of Aug 2026 are exempt.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop care plans.
• Coordinate services and monitor progress toward goals.
• Advocate for members and liaise with physicians and other providers.
• Document all activities in compliance with policies and HIPAA.
• Mentor lower-level Case Managers.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

EHR proficiency

Healthcare systems knowledge

Education

High School/GED

Bachelor's in Nursing

Tools

Microsoft Suite

Case Management Software

Electronic Health Records (EHR)

Job description

Highmark Health is seeking an experienced Case Manager to provide comprehensive case management services, assess member needs, and develop care plans that promote quality and cost-effective care delivery. The role involves coordinating services and monitoring progress while containing healthcare costs.

You will advocate for members, work with physicians and providers, document activities per HIPAA and policy standards, and mentor junior Case Managers in a dynamic health system setting.