Remote RN Care Manager – Weekend Availability

Highmark Health; Arkansas City (KS); Remote; USD 68,000 - 106,000; Full time

Job summary

Highmark Health is seeking a full-time remote Nurse Case Manager to implement care management strategies, review service appropriateness, and coordinate referrals. The role requires weekend availability (Saturday and Sunday) plus three weekdays and focuses on improving member outcomes and provider performance.

We seek ~3 years of RN experience and a Bachelor’s in Nursing preferred; eligibility for PA license or multi-state licensure may be required.

Qualifications

• Bachelor’s Degree in Nursing preferred.
• Approximately 3 years of RN experience.
• RN Case Management or Care Management experience preferred.
• Experience with UM/CM/QA/Managed Care preferred.

Responsibilities

• Implement care management reviews per established criteria and policies.
• Ensure compliance with state, federal laws and regulatory standards.
• Conduct care management reviews using approved guidelines.
• Promote quality and efficiency in care management delivery.
• Protect member privacy and share information as allowed by law.
• Identify and refer members to Health Coaching or case management.
• Educate providers and vendors to streamline processes and improve relations.
• Build positive relationships with internal and external customers.
• Use outcomes data to enhance care management services.
• Perform other duties as assigned.

Skills

Regulatory knowledge

Multitasking

Communication skills

Data analysis

Flexibility

Team player

Prioritization

Computer skills

Education

Bachelor’s Degree in Nursing

Job description

Highmark Health is seeking a full-time remote Nurse Case Manager to implement care management strategies, review service appropriateness, and coordinate referrals. The role requires weekend availability (Saturday and Sunday) plus three weekdays and focuses on improving member outcomes and provider performance.

We seek ~3 years of RN experience and a Bachelor’s in Nursing preferred; eligibility for PA license or multi-state licensure may be required.