Remote Senior RN Case Manager - Complex Care & Advocacy

Highmark Health; Beryl (WV); Hybrid; USD 79.000 - 127.000; Vollzeit

Zusammenfassung

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members, coordinating care plans and resources to optimize health outcomes while containing costs. You will assess needs, develop individualized plans, and monitor progress in collaboration with physicians and the health care team.

You will mentor lower-level staff, document activity per policies, and work in a hybrid/remote office setting with potential travel as needed.

Qualifikationen

• High School/GED is required.
• Bachelor's in Nursing preferred.
• RN licensure or multi-state (eNLC) licensure required.
• CCM certification must be obtained within 36 months of hire.

Aufgaben

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop care plans.
• Coordinate services with physicians and providers.
• Ensure documentation complies with HIPAA and company policies.

Kenntnisse

Clinical assessment & care planning

Leadership & mentoring

Negotiation & advocacy

Healthcare systems & case mgmt

Ausbildung

High School/GED

Bachelors in Nursing

Tools

Microsoft Office Suite

Electronic Health Records (EHR)

Case management software

Jobbeschreibung

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members, coordinating care plans and resources to optimize health outcomes while containing costs. You will assess needs, develop individualized plans, and monitor progress in collaboration with physicians and the health care team.

You will mentor lower-level staff, document activity per policies, and work in a hybrid/remote office setting with potential travel as needed.