Remote RN Case Manager: Complex Care & Advocacy

Highmark Health; Hydaburg (AK); Teletrabalho; USD 114 000 - 140 000; Tempo integral

Resumo da oferta

Highmark Health is seeking a skilled Case Manager to provide comprehensive case management services ensuring quality and cost-effective care. You will assess members, develop and implement care plans, coordinate services, and monitor progress while containing costs.

You will work with physicians and providers, document activities per policy, and mentor junior staff. A nursing background with CCM certification within 36 months is preferred.

Qualificações

• Five years in clinical, case/utilization management, disease condition management, or related health-insurance experience.
• Experience with diverse populations and coordinating complex care.
• Experience with CBT, motivational interviewing, or DBT is preferred.

Responsabilidades

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess health status, needs, and resources; coordinate services.
• Implement and monitor care plans; ensure access to services.
• Advise and mentor lower-level Case Managers; collaborate with healthcare team.

Conhecimentos

Clinical case management

CBT/Motivational Interviewing/DBT

Advanced assessment & care planning

Microsoft Office & EHR

Case management software

Formação académica

Bachelor of Science in Nursing

RN licensure (state)

CCM certification (within 36 months)

Ferramentas

Microsoft Office

Electronic Health Records (EHR)

Descrição da oferta de emprego

Highmark Health is seeking a skilled Case Manager to provide comprehensive case management services ensuring quality and cost-effective care. You will assess members, develop and implement care plans, coordinate services, and monitor progress while containing costs.

You will work with physicians and providers, document activities per policy, and mentor junior staff. A nursing background with CCM certification within 36 months is preferred.