Senior Case Manager RN — Remote Complex-Care Leader

Highmark Health; Mississippi; Remote; USD 114,000 - 140,000; Full time

Job summary

Highmark Health seeks a Case Manager to provide comprehensive case management services, coordinating care for members with complex health needs. You will assess needs, develop care plans, monitor progress, and advocate for cost-effective outcomes in collaboration with physicians and the health care team.

The role requires RN licensure (or multi-state eNLC) and CCM certification within 36 months, with experience in CBT, DBT, and CBT-based interventions.

Qualifications

• 5 years of combined clinical or case management experience.
• Experience with diverse populations.
• CBT, motivational interviewing, or DBT training.
• Proficiency with Microsoft Office, case management software, and EHRs.
• RN licensure in state or multi-state (eNLC).

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop and implement individualized care plans.
• Coordinate services and monitor progress toward goals.
• Advocate and liaise to meet member health care needs.
• Ensure activities are documented and compliant with policies and HIPAA.
• Mentor lower-level Case Managers.
• Collaborate with physicians and providers to carry out the plan of care.

Skills

Clinical knowledge

CBT

Motivational Interviewing

DBT

Care coordination

Nursing licensure

Education

Bachelor of Science in Nursing

Tools

Microsoft Office

Case management software

Electronic Health Records

Job description

Highmark Health seeks a Case Manager to provide comprehensive case management services, coordinating care for members with complex health needs. You will assess needs, develop care plans, monitor progress, and advocate for cost-effective outcomes in collaboration with physicians and the health care team.

The role requires RN licensure (or multi-state eNLC) and CCM certification within 36 months, with experience in CBT, DBT, and CBT-based interventions.