Remote Case Manager: Care Coordination & Outcomes

Highmark Health; United States; Remote; USD 73,000 - 117,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services for members, focusing on quality, cost-effective care and optimal health outcomes.

The role includes assessing needs, developing care plans, coordinating services, and monitoring progress while containing costs. Collaboration with physicians and the health care team is essential to ensure access to appropriate resources and benefits.

Qualifications

• High School Diploma or GED required.
• Bachelor’s Degree in Nursing preferred.
• 3 years in clinical/case management or related healthcare roles required.
• Experience with diverse populations and cultural competency preferred.

Responsibilities

• Manage a caseload of members with moderate complexity health needs.
• Assess members’ health status, needs, and resources.
• Develop individualized care plans with members and providers.
• Coordinate referrals to specialists and community resources.
• Monitor progress and adjust care plans as needed.
• Document activities in accordance with policies and HIPAA.

Skills

Assessment

Care planning

Independent work

Team collaboration

MS Office

EHRs

Case management

Healthcare systems

Education

High School Diploma/GED

Bachelor’s Degree in Nursing

Tools

Case management software

Electronic health records

Job description

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services for members, focusing on quality, cost-effective care and optimal health outcomes.

The role includes assessing needs, developing care plans, coordinating services, and monitoring progress while containing costs. Collaboration with physicians and the health care team is essential to ensure access to appropriate resources and benefits.