Remote Case Manager, Long-Term Care RN

Highmark Health Company

Delaware

Hybrid

USD 73,000 - 117,000

Full time

4 days ago

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Job summary

Highmark Health is seeking a Community-based Case Manager in New Castle County for a RN/LPN role delivering comprehensive case management to DSHP Plus LTSS and DSNP members. The position requires frequent travel for home or site visits to assess needs, develop and implement care plans, evaluate benefits, coordinate services, and monitor progress to ensure quality and cost-effective care.

The role emphasizes advocacy, care transitions, outcome evaluation, regulatory adherence, and benefits

Qualifications

Bachelor's or Master’s degree in Social Work, health or related field required; 3 years in long-term care/home health/hospice/public health/assisted living, or 1 year with Master’s.
Current State RN or LPN licensure or multi-state licensure via eNLC.
Experience with HIV/AIDS, behavioral health, developmental disabilities and managed care preferred.
Substitutions None

Responsibilities

Conduct comprehensive member assessments, visits, and ongoing phone support.
Develop, implement, and monitor individualized care plans addressing multiple needs.
Coordinate access to services and community resources across care settings.
Advocate for members and caregivers to support care goals and decisions.
Ensure seamless care transitions between hospitals, community settings, and facilities.