Senior Case Manager RN (Oncology)

Location: Remote, work from home in Pennsylvania, United States; occasional physical work site required

Company

hirify.global provides health insurance and healthcare services focused on quality, cost-effective care and improved member health outcomes.

What you will do

• Manage a caseload of members with complex health needs using advanced clinical knowledge.
• Conduct comprehensive assessments and develop individualized care plans.
• Coordinate services with members, physicians, providers, and other healthcare professionals.
• Monitor progress, evaluate interventions, and adjust care plans to improve outcomes.
• Advocate for members while identifying, resolving, and preventing improper utilization of benefits.
• Provide clinical guidance and mentorship to lower-level Case Managers.

Requirements

• At least 5 years of combined experience in clinical care, case or utilization management, disease condition management, provider operations, or health insurance.
• Current state Registered Nurse licensure or current multistate licensure through the enhanced Nurse Licensure Compact.
• High school diploma or GED.
• Expertise in oncology assessment and care planning, healthcare systems, and case management principles.
• Strong negotiation, advocacy, communication, leadership, and mentoring skills.
• Certified Case Manager certification must be obtained within 36 months of hire, except for incumbents in the role as of August 2026.

Nice to have

• Oncology-specific clinical experience.
• Bachelor's degree in Nursing.
• Experience supporting diverse populations and applying culturally competent care.
• Training or experience in CBT, motivational interviewing, or DBT.
• Clinical certifications such as OCN, CPN, CPON, CNN, CCTC, or CPHQ.

Culture & Benefits

• Remote or office-based work position with less than 25% travel.
• Occasional physical work site attendance may be required.
• Work must comply with HIPAA, information security policies, regulatory requirements, and accreditation standards.
• Base pay is determined by qualifications, experience, expected contributions, internal equity, market conditions, and business considerations.