Remote Senior Case Manager RN — Complex Care & Outcomes

Highmark Health; Little Elm (TX); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. in Texas is seeking a dedicated Case Manager to provide comprehensive case management services to members, develop and coordinate care plans, and promote quality outcomes while containing health care costs.

You will assess needs, collaborate with physicians and providers, and monitor progress within established contracts and policies. Qualified candidates have 5 years of clinical or utilization management experience, RN licensure, and CCM certification must be obtained within 36

Qualifications

• Requires High School/GED or better.
• RN licensure (state) or multi-state via eNLC.
• CCM certification must be obtained within 36 months of hire.

Responsibilities

• Manage a caseload of members with complex needs; assess health status and resources.
• Develop and coordinate individualized care plans with physicians and providers.
• Monitor progress and evaluate the effectiveness of interventions.

Skills

Clinical assessment

Care planning

Leadership

Negotiation

EHR proficiency

Education

High School Diploma or GED

Bachelor's in Nursing

Tools

Microsoft Office

Case Management Software

Electronic Health Records (EHR)

Job description

Highmark Inc. in Texas is seeking a dedicated Case Manager to provide comprehensive case management services to members, develop and coordinate care plans, and promote quality outcomes while containing health care costs.

You will assess needs, collaborate with physicians and providers, and monitor progress within established contracts and policies. Qualified candidates have 5 years of clinical or utilization management experience, RN licensure, and CCM certification must be obtained within 36