Case Management Nurse – Oncology, Transplant Experience

This is a fully remote position, open to applicants in Arizona, +2 more states.

📋 Description

• Identify members who could benefit from case management through the analysis of claims data, referrals, and clinical records.

• Assess referrals for clinical appropriateness utilizing sound judgment and established program parameters.

• Perform thorough assessments of medical, behavioral, and social needs with a holistic approach.

• Create tailored care plans that reflect the individual needs, obstacles, and objectives of patients.

• Coordinate care throughout the healthcare continuum, including primary care, oncology providers, transplant teams, specialists, behavioral health, and community resources.

• Ensure effective communication among patients, providers, caregivers, and health plans to facilitate safe transitions of care and adherence to treatment protocols.

• Provide telephonic case management for patients with high utilization and complex or chronic conditions.

• Implement best practices in chronic disease management, motivational interviewing, and patient education.

• Advocate for timely, appropriate, and cost-efficient care while balancing clinical judgment with plan guidelines.

• Assist patients in navigating healthcare systems and overcoming access barriers.

• Evaluate precertification requests based on evidence-based criteria and plan-specific guidelines.

• Review ongoing inpatient stays and determine length-of-stay as necessary.

• Accurately document all assessments, interventions, communications, and determinations in ICM systems.

⛳️ Requirements

• Active, unrestricted Registered Nurse (RN) license in good standing.

• Associate’s or Bachelor’s degree in Nursing.

• Over 5 years of clinical nursing experience.

• Recent experience in oncology nursing.

• Recent experience in transplant nursing (including solid organ, living donor, HSCT/BMT, or tissue transplant).

• Extensive knowledge of chronic disease management, utilization management, and social determinants of health.

• Experience in managing complex, high-utilization patient populations.

• Exceptional written and verbal communication skills, demonstrating empathy, professionalism, and emotional intelligence.

• Strong organizational abilities, capable of managing multiple priorities independently.

• Sound clinical judgment and confidence in navigating complex or sensitive situations.

• Comfortable working independently in a remote setting with a strong sense of accountability and follow-through.

• Ability to handle confidential information in compliance with HIPAA regulations.

• Must reside in Iowa, Arizona, or Idaho.

• Availability to work four 10-hour shifts per week and provide support during ICM’s standard operating hours of 8:00 AM–5:00 PM Pacific Time.

🏝️ Benefits

• Flexible work arrangements.

• Opportunities for professional development.