Remote RN Care Manager — Weekend Coverage

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

Job summary

Highmark Health is seeking a remote Care Manager with weekend availability to lead utilization management efforts. You will review service appropriateness, apply criteria, and coordinate with Health Coaches and case management to improve provider and member satisfaction.

The role requires RN licensure (PA or multi-state via eNLC) and about 3 years of related clinical experience, with ability to work in a fast-paced environment and on a remote schedule.

Qualifications

• RN licensure in PA or multi-state licensure via eNLC.
• Minimum ~3 years clinical experience in relevant area.
• Willingness to work weekends and remote schedule.

Responsibilities

• Implement care management review processes per industry and internal standards.
• Comply with applicable state, federal laws and regulations.
• Apply approved criteria, guidelines and policies to reviews.

Skills

Regulatory compliance

Analytical skills

Communication skills

Multitasking

Team collaboration

HIPAA knowledge

Education

Bachelor’s Degree in Nursing

Job description

Highmark Health is seeking a remote Care Manager with weekend availability to lead utilization management efforts. You will review service appropriateness, apply criteria, and coordinate with Health Coaches and case management to improve provider and member satisfaction.

The role requires RN licensure (PA or multi-state via eNLC) and about 3 years of related clinical experience, with ability to work in a fast-paced environment and on a remote schedule.