Hybrid Medical Case Manager – Care Coordination

Highmark Health; Delaware; Hybrid; USD 73,000 - 117,000; Full time

Job summary

Highmark Health is seeking a full-time Case Manager for hybrid work from home and community-based settings. You will frequently travel within the assigned territory to assess members, develop care plans, and coordinate services with physicians and providers.

You will monitor progress, contain costs, and ensure compliant care delivery while advocating for members and collaborating with the health care team. Strong organizational and communication skills are required.

Qualifications

• Bachelor’s degree in nursing with RN licensure or Master’s in Social Work.
• Bachelor’s degree in Social Work preferred.
• Professional licenses may be required (LSW/LCSW/LMSW/LGSW or RN).

Responsibilities

• Manage a caseload of members with moderate complexity health needs.
• Assess members’ health status, needs, and resources.
• Develop individualized care plans with members, physicians, and providers.
• Implement and coordinate care plans to ensure access to services.
• Coordinate referrals to specialists and community resources.
• Monitor progress and adjust care plans as needed.
• Evaluate interventions and advocate for members’ needs.
• Document activities in compliance with policies and standards.

Skills

Assessment skills

Care planning

Independence

Teamwork

MS Office

Case management software

Electronic Health Records

Healthcare systems

Bilingual English/Spanish

Education

Bachelor’s degree in nursing or RN licensure or MSW

Bachelor’s degree in Social Work

Licenses (LSW/LCSW/LMSW/LGSW/LCSW)

Tools

MS Office

Case management software

Electronic Health Records

Job description

Highmark Health is seeking a full-time Case Manager for hybrid work from home and community-based settings. You will frequently travel within the assigned territory to assess members, develop care plans, and coordinate services with physicians and providers.

You will monitor progress, contain costs, and ensure compliant care delivery while advocating for members and collaborating with the health care team. Strong organizational and communication skills are required.