Senior Case Manager RN — Remote Care Coordination Leader

Highmark Health; Montana City (MT); Remote; USD 60.000 - 86.000; Vollzeit

Zusammenfassung

Highmark Health in the United States seeks an experienced Case Manager to provide comprehensive case management services, assess member needs, develop and coordinate care plans, and monitor outcomes to ensure quality and cost-effective care.

You will collaborate with physicians, providers, and care teams, document activities in accordance with HIPAA and policies, mentor junior staff, and contribute to continuous improvement in member health and satisfaction.

Qualifikationen

• Bachelors in Nursing required.
• RN licensure (state) or eNLC.
• CCM certification must be obtained within 36 months of hire.

Aufgaben

• Manage a caseload of members with complex health needs.
• Develop and implement individualized care plans.
• Coordinate services and monitor progress toward goals.
• Advocate for members and contain costs.
• Collaborate with physicians and healthcare providers.
• Document activities per policies, HIPAA, and regulatory requirements.
• Mentor junior Case Managers.

Kenntnisse

CBT training

DBT training

Clinical assessment

Care planning

Microsoft Office

Healthcare systems

Ausbildung

Bachelor of Science in Nursing

RN licensure

Tools

Microsoft Office

Electronic Health Records

Case management software

Jobbeschreibung

Highmark Health in the United States seeks an experienced Case Manager to provide comprehensive case management services, assess member needs, develop and coordinate care plans, and monitor outcomes to ensure quality and cost-effective care.

You will collaborate with physicians, providers, and care teams, document activities in accordance with HIPAA and policies, mentor junior staff, and contribute to continuous improvement in member health and satisfaction.