Case Manager - Cost Estimates

Responsibilities Develop accurate, clinically grounded cost estimates for patient treatment plans across care settings. Build detailed financial projections by translating physician orders, care pathways, and clinical documentation into itemized, defensible cost estimates. Price treatment episodes prior to care delivery for self-pay, international, and insured patients. Perform concurrent and post-treatment reviews, updating estimates based on patient progress. Partner with physicians, nursing staff, and multidisciplinary teams to validate clinical assumptions. Break down anticipated services including labs, imaging, procedures, medications, and therapies. Apply historical utilization data and patient-specific risk factors to build scenario-based estimates. Collaborate with internal departments to ensure timely pricing, billing alignment, and patient-centered outcomes. Contribute to workflow improvement initiatives and development of standardized cost estimation tools. Requirements Bachelor’s degree in Nursing or related field required. Actively holds or has previously obtained an RN license. 2–4 years of clinical experience required; oncology experience preferred. Experience in managed care, utilization review, or case management preferred. Knowledge of hospital billing practices and healthcare financial workflows preferred. Familiarity with clinical coding systems (ICD-10-CM, CPT, HCPCS) and healthcare data interpretation preferred. #J-18808-Ljbffr Jobtailor