Remote Senior RN Case Manager: Complex Care & Advocacy

Highmark Health; Dover (DE); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services for members, develop care plans, coordinate services, and monitor progress with a focus on cost containment.

Requires 5 years of clinical/case management experience; RN licensure and CCM certification are preferred or required within 36 months. Office-based or remote work options with limited travel support HIPAA compliance.

Qualifications

• High School/GED required.
• Bachelor's in Nursing preferred.
• Current State RN licensure or multi-state via eNLC preferred.
• CCM certification due within 36 months of hire (exempt for incumbents as of Aug 2026).

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop and implement individualized care plans with stakeholders.
• Coordinate services and monitor progress toward goals.
• Advocate for patients and communicate with providers clearly.
• Document activities per policies and regulatory requirements.

Skills

Clinical assessment

Care planning

Leadership

Negotiation

Advocacy

Microsoft Office

EHR systems

Healthcare systems

Education

High School/GED

Bachelors in Nursing

Tools

MS Office

EHR software

Job description

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services for members, develop care plans, coordinate services, and monitor progress with a focus on cost containment.

Requires 5 years of clinical/case management experience; RN licensure and CCM certification are preferred or required within 36 months. Office-based or remote work options with limited travel support HIPAA compliance.