Remote RN Case Manager: Coordinating Care & Outcomes

Highmark Health; Kansas City (MO); Hybride; USD 108 000 - 146 000; Plein temps

Résumé du poste

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, assess member needs, and coordinate care to promote optimal health outcomes.

The role involves developing and implementing care plans, monitoring progress, and advocating for members while ensuring adherence to policies and regulatory standards. Strong clinical knowledge and collaboration with healthcare teams are essential.

Qualifications

• Bachelor’s degree in Nursing or registered nurse licensure is required.
• RN licensure current or multi-state licensure via eNLC.
• CCM certification must be obtained within 36 months of hire.
• Experience with CBT/MI/DBT preferred.
• Strong understanding of case management principles and healthcare systems.

Responsabilités

• Manage a caseload of members with complex health needs and coordinate comprehensive care plans.
• Assess health status, needs, and resources; develop individualized care plans in collaboration with providers.
• Implement and monitor care plans to ensure access to appropriate services and cost-effective outcomes.
• Act as advocate and liaison to meet members' health care needs; document activities per policies.
• Mentor lower-level Case Managers and provide clinical guidance.

Connaissances

5 years of clinical/case management

CBT/Motivational interviewing/DBT

MS Office proficiency

effective communication

team collaboration

English language

Formation

Bachelors in Nursing (BSN) or RN licensure

Current RN licensure or eNLC

CCM certification required within 36 months

Outils

Electronic Health Records (EHR)

Case management software

Microsoft Office

Description du poste

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, assess member needs, and coordinate care to promote optimal health outcomes.

The role involves developing and implementing care plans, monitoring progress, and advocating for members while ensuring adherence to policies and regulatory standards. Strong clinical knowledge and collaboration with healthcare teams are essential.