Complex Case Manager RN - Maternity, NICU (Remote)

Lensa; Raleigh (NC); Remote; USD 57,000 - 108,000; Full time

Job summary

An established industry player is seeking a Complex Case Manager RN to oversee a diverse panel of members. This remote position involves assessing health management needs, developing tailored care plans, and coordinating resources to enhance patient outcomes. The ideal candidate will have extensive experience in clinical settings, particularly in maternity or NICU care. Join a team committed to improving health results through innovative care management strategies. If you thrive in a dynamic environment and are passionate about patient care, this opportunity is perfect for you.

Qualifications

• 7+ years in clinical, case management, or related fields.
• Maternity or NICU experience preferred.

Responsibilities

• Manage a panel of members and assess their health needs.
• Develop care plans and monitor patient outcomes.
• Coordinate care and encourage behavioral changes.

Skills

Communication Skills

Negotiation Skills

Interpersonal Skills

Data Analysis

Knowledge of Disease Processes

Ability to Handle Multiple Priorities

Education

High School Diploma/GED

Bachelor's in Nursing

Tools

MS Excel

Job description

Complex Case Manager RN - Maternity, NICU (Remote)

2 days ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, Highmark Health, is seeking professionals. Apply via Lensa today!

Company: Highmark Inc.

Job Description:

Job Summary

This role involves managing a panel of members with varying health statuses and needs. The incumbent assesses health management needs, uses data and clinical judgment to identify interventions, and refers members to multidisciplinary resources. Responsibilities include developing care plans, encouraging behavioral changes, addressing barriers, coordinating care, and monitoring outcomes to improve clinical, financial, and functional results.

Essential Responsibilities

• Oversee a panel of members, assess their needs, and triage to resources.
• Create and implement care plans with goals and follow-up schedules.
• Achieve targeted patient outcomes and document activities in compliance with standards.
• Stay current with applicable regulations and standards of practice.
• Perform other duties as assigned.

Minimum Requirements

Education: High School Diploma/GED required; Bachelor's in Nursing preferred.

Experience: Minimum 7 years in clinical, case management, or related fields; maternity or NICU experience preferred.

Licenses and Certifications: Valid RN license in PA, WV, DE, or NY; certification in case management preferred.

Skills

• Strong communication, negotiation, and interpersonal skills.
• Knowledge of disease processes and healthcare systems.
• Proficiency in MS Excel and data analysis.
• Ability to handle multiple priorities and work autonomously.

Additional Details

Position is office-based with travel requirements of 0-25%. Physical demands include light lifting. The role complies with HIPAA and company policies. Salary range: $57,700 - $107,800.