Senior Case Manager RN — Complex Care & Advocacy (Remote)

Highmark Health; Arkansas City (KS); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a seasoned Case Manager to deliver comprehensive case management services for members, coordinate care and monitor outcomes while containing costs.

The role emphasizes clinical expertise, complex care planning, and collaboration with physicians and the health team. Strong leadership and advocacy skills are essential, with a requirement for RN licensure (or eNLC) and CCM certification within 36 months of hire.

Qualifications

• 5 years in clinical, case/utilization management, and/or health insurance experience.
• RN licensure (state) or eNLC eligibility.
• CCM certification to be obtained within 36 months of hire (exempt for incumbents as of Aug 2026).

Responsibilities

• Manage a caseload of members with complex health needs and coordinate care.
• Develop and implement individualized care plans with providers.
• Monitor progress, adjust plans, and document activities per policy.
• Advocate for patients and ensure cost-effective, quality outcomes.
• Mentor lower-level Case Managers and collaborate with the health team.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

Microsoft Office

Case management software

Electronic Health Records

Education

High School/GED

Bachelors in Nursing

Tools

Microsoft Office

Case management software

Electronic Health Records

Job description

Highmark Inc. is seeking a seasoned Case Manager to deliver comprehensive case management services for members, coordinate care and monitor outcomes while containing costs.

The role emphasizes clinical expertise, complex care planning, and collaboration with physicians and the health team. Strong leadership and advocacy skills are essential, with a requirement for RN licensure (or eNLC) and CCM certification within 36 months of hire.