RN Case Manager: Care Coordinator for Outcomes

Highmark Health

Denver (CO)

Remote

USD 73,000 - 117,000

Full time

3 days ago

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Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services, coordinating care, assessing member needs, and implementing care plans to promote quality, cost-effective health outcomes.

The role involves working with physicians and providers, ensuring access to services, and advocating for members within contract benefits. Responsibilities include managing a caseload, collaborating with a multidisciplinary team, and monitoring progress while containing healthcare

Qualifications

Required: High School Diploma or GED.
Preferred: Bachelor's Degree in Nursing.

Responsibilities

Manage a caseload of members with moderate complexity health needs.
Assess members’ health status, needs, and available resources.
Develop individualized care plans in collaboration with members, physicians, and other healthcare providers.
Implement and coordinate care plans, ensuring access to appropriate services and resources.
Coordinate referrals to specialists and community resources.
Monitor member progress toward goals and adjust care plans as needed.
Evaluate the effectiveness of interventions and services.
Act as an advocate and liaison to meet a member's individual health care needs using resources to promote quality outcomes.