RN Case Manager: Care Coordinator & Advocate

Highmark Health; Salt Lake City (UT); Remote; USD 73,000 - 117,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services for members, coordinating care and promoting quality and cost-effective outcomes. You will assess needs, develop care plans, and monitor progress within a HIPAA-compliant framework.

The role requires strong clinical judgment, 3 years of relevant experience, and an RN license in PA or multi-state licensure. Travel up to 25% may be part of duties.

Qualifications

• High School Diploma or GED required.
• Preferred Bachelor's in Nursing.
• 3 years in clinical/case management or related health-insurance roles.

Responsibilities

• Manage a caseload of members with moderate complexity health needs.
• Assess health status, needs and resources; develop care plans.
• Coordinate referrals to specialists and community resources.
• Monitor progress and adjust plans as needed.
• Ensure documentation complies with HIPAA and company policies.

Skills

Care planning

Assessment

Independent work

EHR knowledge

MS Office

Education

High School Diploma/GED

Bachelor's Degree in Nursing (preferred)

Tools

Case management software

Electronic Health Records

Microsoft Office

Job description

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services for members, coordinating care and promoting quality and cost-effective outcomes. You will assess needs, develop care plans, and monitor progress within a HIPAA-compliant framework.

The role requires strong clinical judgment, 3 years of relevant experience, and an RN license in PA or multi-state licensure. Travel up to 25% may be part of duties.