Case Manager - Cost Estimates
About The Position
The Case Manager, Cost Estimates plays a unique role bridging clinical care and healthcare finance, translating treatment plans into accurate cost projections while driving transparency, collaboration, and process improvement across multidisciplinary teams. While clinical knowledge informs the work, the day-to-day centers on hands-on data analysis and financial modeling rather than the direct patient management of traditional complex-care or bedside case management. We're looking for someone energized by turning clinical insight into accurate, transparent financial projections that ultimately support our patients and our mission.
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
- Strong quantitative and analytical skills, including the ability to build, manipulate, and interpret data-driven financial models
- Strong proficiency in Excel (lookup functions, data modeling)
- Effective communication and collaboration across multidisciplinary teams
- High attention to detail and accuracy in documentation and cost estimation
- Problem-solving agility and ability to navigate complex, evolving clinical scenarios
- Clinical judgment applied to financial modeling
Nice To Haves
- 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
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
Benefits
- Fair, competitive pay that reflects your job, experience, and skills.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
