Remote RN Case Manager — Complex Care & Advocacy

highmarkhealth; United States; Hybrid; USD 77,000 - 94,000; Full time

Benefits offered by this job

Mentorship to junior staff

Remote/office-based option

Job summary

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services and optimize health outcomes while containing costs. You will assess member needs, develop and implement care plans in collaboration with physicians and providers, and monitor progress.

This role requires RN licensure (or eNLC) and CCM certification to be obtained within 36 months of hire. The position supports office-based or remote work with some travel, and offers mentorship to junior staff.

Qualifications

• 5 years in clinical, case/utilization management, or disease condition management experience.
• Experience with diverse populations and culture competency.
• Advanced training in CBT, motivational interviewing, or DBT is a plus.

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop and implement individualized care plans with providers.
• Coordinate services and monitor progress toward goals.
• Advise and mentor lower-level Case Managers.
• Ensure documentation adheres to policies and compliance requirements.

Job description

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services and optimize health outcomes while containing costs. You will assess member needs, develop and implement care plans in collaboration with physicians and providers, and monitor progress.

This role requires RN licensure (or eNLC) and CCM certification to be obtained within 36 months of hire. The position supports office-based or remote work with some travel, and offers mentorship to junior staff.