RN Case Manager: Care Coordination & Cost-Saving

Highmark Health; Little Rock (AR); Remote; USD 73,000 - 117,000; Full time

Job summary

Highmark Health in Little Rock, AR seeks a Case Manager to deliver comprehensive case management, promoting quality and cost-effective care. You will assess needs, develop and implement care plans, and coordinate services across the health care team.

The role requires RN licensure, 3 years in relevant fields, strong assessment skills, and proficiency with Microsoft Office and EHR systems. Travel 0–25% and ongoing documentation and compliance are essential.

Qualifications

• 3 years in clinical, case/utilization management, or disease condition management experience
• RN licensure (PA, multi-state via eNLC, WV, DE or NY) with 6-month deadline
• Strong assessment and care planning skills
• Ability to work independently and in a team
• Proficient in Microsoft Office and EHR systems with knowledge of healthcare systems

Responsibilities

• Manage a caseload of members with moderate complexity health needs.
• Assess members’ health status, needs, and available resources.
• Develop individualized care plans with members, physicians, and other providers.
• Coordinate referrals to specialists and community resources.
• Implement and coordinate care plans, ensuring access to services.
• Monitor member progress and adjust care plans as needed.
• Evaluate the effectiveness of interventions and services.
• Advocate and liaise to meet members’ health care needs per contract benefits.
• Document activities in compliance with policies and regulations.

Skills

Assessment skills

Care planning

Teamwork

MS Office

EHR systems

Healthcare knowledge

Education

High School Diploma

Bachelor's Degree in Nursing

Tools

Case management software

Electronic Health Records

Job description

Highmark Health in Little Rock, AR seeks a Case Manager to deliver comprehensive case management, promoting quality and cost-effective care. You will assess needs, develop and implement care plans, and coordinate services across the health care team.

The role requires RN licensure, 3 years in relevant fields, strong assessment skills, and proficiency with Microsoft Office and EHR systems. Travel 0–25% and ongoing documentation and compliance are essential.