Remote Senior RN Case Manager — Care Coordination Leader

Highmark Health; Tennessee; Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services to members, assess needs, develop care plans, coordinate services, and monitor progress while containing costs. The role requires 5 years of relevant experience and RN licensure with CCM certification within 36 months.

The position can be office-based or remote with less than 25% travel. Strong collaboration with physicians and healthcare teams is essential to ensure high-quality,

Qualifications

• Experience in case management or utilization management.
• Clinical assessment and care planning expertise.
• Ability to coordinate care across multiple providers.

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop and coordinate comprehensive care plans.
• Monitor progress and adjust plans to achieve goals.
• Collaborate with physicians and other providers to meet member needs.

Skills

Clinical assessment

Care planning

Leadership

Mentoring

Advocacy

EHR systems

Microsoft Office

Education

High School/GED

Bachelor's in Nursing

Tools

Case management software

Electronic Health Records

Job description

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services to members, assess needs, develop care plans, coordinate services, and monitor progress while containing costs. The role requires 5 years of relevant experience and RN licensure with CCM certification within 36 months.

The position can be office-based or remote with less than 25% travel. Strong collaboration with physicians and healthcare teams is essential to ensure high-quality,