Senior Case Manager RN - Remote Care Strategy Lead

Embedded Shishya; United States; Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management to members, ensuring quality and cost-effective care. You will assess needs, develop and implement care plans, coordinate services and monitor progress while containing costs.

The role requires collaboration with physicians, providers and the health team to meet member health goals. Responsibilities include managing complex caseloads, ensuring documentation, and mentoring junior Case Managers.

Qualifications

• Clinical assessment and care planning expertise.
• Strong leadership and mentoring abilities.
• Excellent negotiation and advocacy skills.
• Proficient in Microsoft Office and EHR systems.

Responsibilities

• Manage a caseload of members with complex health needs and coordinate care.
• Conduct comprehensive assessments and develop individualized care plans.
• Monitor progress and adjust plans to meet goals.
• Collaborate with members, physicians and providers to ensure access to services.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

EHR systems

Education

High School/GED

Bachelor's in Nursing (preferred)

Tools

MS Office

Electronic Health Records

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management to members, ensuring quality and cost-effective care. You will assess needs, develop and implement care plans, coordinate services and monitor progress while containing costs.

The role requires collaboration with physicians, providers and the health team to meet member health goals. Responsibilities include managing complex caseloads, ensuring documentation, and mentoring junior Case Managers.