Case Manager - Cost Estimates

Responsibilities

• Develop accurate, clinically grounded cost estimates for patient treatment plans across various care settings
• Build detailed financial projections by translating physician orders, care pathways, and clinical documentation into itemized 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 the development of standardized cost estimation tools

Requirements

• Bachelor’s degree in Nursing or a related field
• Active or previously obtained RN license
• 2–4 years of clinical experience
• Strong quantitative and analytical skills with the ability to build and interpret data-driven financial models
• Proficiency in Microsoft Excel (including lookup functions and data modeling)

Preferred Qualifications

• Oncology clinical experience
• Experience in managed care, utilization review, or case management
• Knowledge of hospital billing practices and healthcare financial workflows
• Familiarity with clinical coding systems (ICD-10-CM, CPT, HCPCS)

About the Company

Memorial Sloan Kettering Cancer Center (MSK) is a world-renowned cancer center dedicated to patient care, research, and innovation. Our mission is ending cancer for life through personalized, compassionate, and expert care informed by groundbreaking research.