Remote Senior RN Case Manager - Complex Care Coordination

Highmark Health; Salt Lake City (UT); Teletrabalho; USD 79 000 - 127 000; Tempo integral

Resumo da oferta

Highmark Inc. is seeking an experienced Case Manager to deliver comprehensive case management services for members, coordinating care plans and resources to promote optimal health outcomes while containing costs.

You will assess member needs and collaborate with physicians and providers to implement appropriate plans. The role requires strong clinical assessment, care planning, leadership, and advocacy skills, with documentation in EMR and case management systems.

Qualificações

• 5 years in clinical, case/utilization management, disease condition management, or related healthcare operations/insurance.
• Preferred experience with diverse populations and culture competency.

Responsabilidades

• Manage a caseload of members with complex health needs requiring advanced clinical knowledge.
• Develop and implement individualized care plans in collaboration with members and providers.
• Coordinate access to services and monitor progress toward goals.
• Act as advocate and liaison to ensure quality, cost-effective outcomes.
• Document activities in compliance with policies and regulatory requirements.

Conhecimentos

Clinical assessment

Care planning

Leadership & mentoring

Advocacy

Microsoft Office / EMR systems

Healthcare systems knowledge

Formação académica

High School/GED

Bachelor's in Nursing (preferred)

Ferramentas

Case management software

Electronic Health Records

Descrição da oferta de emprego

Highmark Inc. is seeking an experienced Case Manager to deliver comprehensive case management services for members, coordinating care plans and resources to promote optimal health outcomes while containing costs.

You will assess member needs and collaborate with physicians and providers to implement appropriate plans. The role requires strong clinical assessment, care planning, leadership, and advocacy skills, with documentation in EMR and case management systems.