Remote RN Case Manager — Care Coordination & Outcomes

Highmark Health; New York (NY); A distancia; USD 73.000 - 117.000; Jornada completa

Descripción de la vacante

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services, ensuring quality and cost-effective care delivery for members in New York.

You will assess needs, develop care plans, coordinate services, and monitor progress to promote optimal health outcomes while containing costs. The role requires collaboration with physicians and health care teams, strong documentation, and adherence to policies and regulatory standards.

Formación

• Requires 3 years in clinical, case/utilization management, disease condition management, or related health insurance roles.
• Experience with diverse populations and cultural competency is preferred.
• Strong assessment, care planning, and documentation skills are essential.

Responsabilidades

• Manage a caseload of members with moderate complexity health needs.
• Assess members' health status, needs, and available resources.
• Develop individualized care plans with members, physicians, and providers.

Conocimientos

Assessment skills

Care planning

Teamwork

MS Office / EHR

Healthcare systems knowledge

Educación

High School Diploma/GED

Bachelor's Degree in Nursing

Herramientas

Case management software

Electronic Health Records

Descripción del empleo

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services, ensuring quality and cost-effective care delivery for members in New York.

You will assess needs, develop care plans, coordinate services, and monitor progress to promote optimal health outcomes while containing costs. The role requires collaboration with physicians and health care teams, strong documentation, and adherence to policies and regulatory standards.