Remote RN Care Manager — Weekend Availability

Highmark Health; Wilmington (VT); Remote; USD 68,000 - 106,000; Full time

Job summary

Highmark Health is seeking a full-time RN-based care management professional for a REMOTE position requiring weekend availability (Saturday and Sunday) plus three weekdays. The role focuses on utilization management, coordinating care, and improving provider and member outcomes across UM/CM processes.

The candidate should have 3+ years of clinical experience and RN licensure (PA or eNLC). Bachelor’s in Nursing preferred; certification in Utilization Management is a plus.

Qualifications

• This role requires RN licensure and clinical experience in care management.
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Responsibilities

• Implement care management reviews according to established criteria and policies.
• Promote quality and efficiency in care management services.
• Ensure privacy and confidentiality of member information.
• Refer members to Health Coaching/case management when appropriate.
• Educate providers and vendors to streamline processes and improve outcomes.
• Develop and sustain positive relationships with internal and external customers.
• Use outcomes data to improve care management services.
• Perform other duties as assigned.

Skills

Regulatory knowledge

Multitasking

Written & verbal communication

Data analysis

Team player

Prioritization

Computer skills

Adaptability

Education

Bachelor's Degree in Nursing

Tools

Regulatory policies

Health IT systems

Job description

Highmark Health is seeking a full-time RN-based care management professional for a REMOTE position requiring weekend availability (Saturday and Sunday) plus three weekdays. The role focuses on utilization management, coordinating care, and improving provider and member outcomes across UM/CM processes.

The candidate should have 3+ years of clinical experience and RN licensure (PA or eNLC). Bachelor’s in Nursing preferred; certification in Utilization Management is a plus.