Complex Case Manager RN - Remote

Highmark; Pennsylvania; Remote; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare company is seeking a Complex Case Manager RN to manage a diverse panel of members. This remote role involves developing care plans, coordinating care, and ensuring compliance with regulatory standards. Ideal candidates will have strong communication and analytical skills, along with a solid healthcare background. Join a multidisciplinary team dedicated to improving health outcomes.

Qualifications

• 7 years of clinical, case management, or related experience.
• RN license in PA, WV, DE, or NY; other licenses within 6 months.

Responsibilities

• Oversee a panel of members and coordinate interventions.
• Create and implement care plans with goals.
• Document activities in compliance with standards.

Skills

Communication

Analytical Skills

Healthcare Knowledge

Teamwork

Education

High School Diploma/GED

Bachelor's in Nursing

Job description

Join to apply for the Complex Case Manager RN - Remote role at Highmark.

This role involves managing a panel of members with diverse health needs, assessing their health management requirements, and utilizing data and clinical judgment to identify appropriate interventions. The incumbent will develop care plans, coordinate care, and work with a multidisciplinary team to improve health outcomes, ensuring compliance with regulatory standards.

Key Responsibilities:

• Oversee a panel of members, assess their health needs, and coordinate interventions.
• Create and implement care plans with goals and regular re-assessments.
• Document all activities in compliance with standards and regulations.
• Maintain knowledge of CMS, state, and local requirements for case management.

Minimum Requirements:

• High School Diploma/GED; Bachelor's in Nursing preferred.
• 7 years of clinical, case management, or related experience.
• RN license in PA, WV, DE, or NY; other licenses within 6 months.

Skills: Strong communication, analytical skills, healthcare knowledge, and ability to work independently and in a team environment.