Remote Case Manager: Nurse-Led Care Coordination

highmarkhealth; Pennsylvania; Híbrido; USD 73 000 - 117 000; Tempo integral

Resumo da oferta

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

You will assess member needs, develop and implement care plans, coordinate services, monitor progress, and advocate for patients within contract benefits. Required PA RN licensure (or multi-state license via eNLC), 3 years of related experience, and a Bachelor's in Nursing preferred.

Qualificações

• 3 years in clinical, case/utilization management, or disease condition management or healthcare operations experience.
• Ability to work with diverse populations and demonstrate cultural competency.
• Strong assessment and care planning skills; proficient with EHRs and MS Office.

Responsabilidades

• Manage a caseload of members with moderate complexity health needs.
• Assess health status, needs and available resources; develop individualized care plans.
• Coordinate referrals to specialists and community resources.
• Monitor progress and adjust care plans; evaluate intervention effectiveness.
• Document activities in compliance with policies and regulatory standards.

Descrição da oferta de emprego

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

You will assess member needs, develop and implement care plans, coordinate services, monitor progress, and advocate for patients within contract benefits. Required PA RN licensure (or multi-state license via eNLC), 3 years of related experience, and a Bachelor's in Nursing preferred.