Senior Case Manager RN — Remote Care Advocate

Highmark Health; Kansas; À distance; USD 79 000 - 127 000; Plein temps

Résumé du poste

Highmark Inc. is seeking an experienced Case Manager to deliver comprehensive case management services for members, coordinating services, developing care plans, and monitoring progress to achieve quality, cost-effective outcomes.

The role requires assessing health needs, collaborating with physicians and providers, ensuring access to appropriate resources, documenting activities, and mentoring junior Case Managers while upholding HIPAA and policy standards.

Qualifications

• Must have a clinical background with case/utilization management experience.
• Strong leadership and mentoring abilities to guide junior staff.
• Experience with advocacy and negotiating for patient access to services.

Responsabilités

• Manage a caseload of members with complex health needs.
• Develop and implement individualized care plans in collaboration with care team.
• Coordinate services and monitor progress toward goals.
• Document all activities in compliance with policies and regulations.
• Mentor lower-level Case Managers and act as a clinical resource.

Connaissances

Clinical assessment

Care planning

Leadership

Advocacy

EHR proficiency

Healthcare systems knowledge

Formation

High School/GED

Bachelors in Nursing

Outils

Microsoft Office

Case management software

Electronic Health Records (EHR)

Description du poste

Highmark Inc. is seeking an experienced Case Manager to deliver comprehensive case management services for members, coordinating services, developing care plans, and monitoring progress to achieve quality, cost-effective outcomes.

The role requires assessing health needs, collaborating with physicians and providers, ensuring access to appropriate resources, documenting activities, and mentoring junior Case Managers while upholding HIPAA and policy standards.