RN Case Manager: Care Coordination & Outcomes

Highmark Health; United States; Remote; USD 73,000 - 117,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management services, coordinate care, and promote optimal health outcomes for members. Responsibilities include assessing needs, developing care plans, coordinating services, and monitoring progress while containing healthcare costs.

Preferred education includes a Bachelor's in Nursing and licensure in PA or multi-state Compact. 3 years of related experience and proficiency with EHR systems are expected.

Qualifications

• 3 years in clinical, case/utilization, or disease management experience
• Experience with diverse populations and cultural competency
• State RN license required or multi-state licensure via compact

Responsibilities

• Manage a caseload of members with moderate complexity health needs
• Assess health status, needs and resources
• Develop individualized care plans with members and providers
• Coordinate referrals to specialists and community resources
• Monitor progress and adjust care plans as needed
• Advocate for member needs and ensure compliant care delivery

Skills

Assessment skills

Care planning

Independence

Microsoft Office

Education

High School Diploma

Bachelor's in Nursing

Tools

Case mgmt software

EHR systems

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management services, coordinate care, and promote optimal health outcomes for members. Responsibilities include assessing needs, developing care plans, coordinating services, and monitoring progress while containing healthcare costs.

Preferred education includes a Bachelor's in Nursing and licensure in PA or multi-state Compact. 3 years of related experience and proficiency with EHR systems are expected.