Remote RN Care Manager – Weekend Availability

Highmark Health; Clayton (MO); Remote; USD 68,000 - 106,000; Full time

Job summary

Highmark Inc. is seeking a Nurse Care Manager for a fully remote role with weekend availability (Saturday and Sunday) in addition to three weekdays. The role focuses on utilization management, quality improvement, and member/provider education to optimize health outcomes.

The position requires 3+ years of clinical experience, RN licensure (PA or multi-state via eNLC), and preferably a Nursing Bachelor's. Prior UM/CM exposure is advantageous; travel is variable.

Qualifications

• 3 years of related, progressive clinical experience in the area of specialization.
• Experience in a clinical setting.
• Knowledge of utilization management preferred.

Responsibilities

• Implement care management review processes that align with industry and corporate standards.
• Promote quality and efficiency in care management services.
• Educate providers and vendors to streamline processes and improve outcomes.
• Develop and sustain positive working relationships with internal and external customers.
• Utilize outcomes data to improve ongoing care management services.

Skills

Nursing knowledge

Data analysis

Regulatory compliance

Communication

Team collaboration

Education

Bachelor's in Nursing

Job description

Highmark Inc. is seeking a Nurse Care Manager for a fully remote role with weekend availability (Saturday and Sunday) in addition to three weekdays. The role focuses on utilization management, quality improvement, and member/provider education to optimize health outcomes.

The position requires 3+ years of clinical experience, RN licensure (PA or multi-state via eNLC), and preferably a Nursing Bachelor's. Prior UM/CM exposure is advantageous; travel is variable.