RN Case Manager: Lead Coordinated Care & Outcomes

Highmark Health; Austin (TX); Remote; USD 72,000 - 117,000; Full time

Job summary

Highmark Inc. in Austin, TX, seeks a Case Manager to provide comprehensive case management services to members,coordinate care, and promote quality, cost-effective outcomes while containing health care costs.

Requires 3 years in clinical or case management, PA RN licensure (or multi-state eNLC), and a High School Diploma/GED. Bachelor’s in Nursing preferred. Office-based role with 0–25% travel; proficient in MS Office and EHR.

Qualifications

• Requires High School Diploma or GED.
• Bachelor's Degree in Nursing preferred.
• 3 years in clinical/case management or related health insurance operations are required.

Responsibilities

• Manage a caseload of members with moderate complexity health needs.
• Assess members’ health status, needs, and resources.
• Develop individualized care plans with members and providers.
• Coordinate referrals to specialists and community resources.
• Monitor progress and adjust plans to meet goals.

Skills

Assessment

Care planning

Teamwork

Microsoft Office

Case management software

Electronic health records

Education

High School Diploma/GED

Bachelor's Degree in Nursing

Tools

Microsoft Suite

Case management software

Electronic health records

Job description

Highmark Inc. in Austin, TX, seeks a Case Manager to provide comprehensive case management services to members,coordinate care, and promote quality, cost-effective outcomes while containing health care costs.

Requires 3 years in clinical or case management, PA RN licensure (or multi-state eNLC), and a High School Diploma/GED. Bachelor’s in Nursing preferred. Office-based role with 0–25% travel; proficient in MS Office and EHR.