Remote Senior RN Case Manager: Complex Care & Coordination

Highmark Health; Lincoln (NE); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive management for members with complex health needs. You will assess, plan, coordinate, and monitor care to promote quality, cost-effective outcomes.

Strong clinical and advocacy skills are essential to partner with physicians and health teams. Requirements include RN licensure (state or eNLC) and CCM certification within 36 months, with preferred CBT/DBT training and experience serving diverse populations.

Qualifications

• 5 years in clinical, case/utilization management, or disease management.
• RN licensure and CCM certification within 36 months.
• Experience with diverse populations and CBT/MBT training preferred.

Responsibilities

• Manage a caseload of members with complex health needs.
• Assess needs and develop individualized care plans.
• Coordinate services and monitor progress toward goals.
• Advocate for cost-effective care and optimal outcomes.
• Document activities in accordance with policies.
• Mentor lower-level Case Managers.
• Collaborate with physicians and other providers.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

EHR / Case management software

Education

RN licensure (state) or multi-state eNLC

CCM certification within 36 months

Bachelor's in Nursing (preferred)

Tools

EHR

Case management software

Microsoft Office

Job description

Highmark Health is seeking a Case Manager to provide comprehensive management for members with complex health needs. You will assess, plan, coordinate, and monitor care to promote quality, cost-effective outcomes.

Strong clinical and advocacy skills are essential to partner with physicians and health teams. Requirements include RN licensure (state or eNLC) and CCM certification within 36 months, with preferred CBT/DBT training and experience serving diverse populations.