Senior RN Case Manager - Care Coordination Leader (Remote)

Highmark Health; Texas; Remoto; USD 114.000 - 140.000; Tempo pieno

Descrizione del lavoro

Highmark Health is seeking a Case Manager to provide comprehensive case management services, assess member needs, and coordinate care plans to promote quality, cost-effective outcomes.

The role involves collaborating with physicians and the health care team, monitoring progress, and ensuring compliance with HIPAA and company policies. Strong clinical knowledge and licensure are required.

Competenze

• RN licensure required (state or multi-state eNLC).
• CCM certification must be obtained within 36 months of hire.
• Minimum 5 years in clinical/case management or related health insurance operations.

Mansioni

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop care plans.
• Coordinate services and monitor progress toward goals.
• Act as an advocate and liaison to meet individual health care needs.
• Document all activities in accordance with policies and regulations.

Conoscenze

CBT

Motivational interviewing

DBT

Clinical assessment

Care planning

Microsoft Office

Electronic Health Records

Healthcare systems knowledge

Formazione

Bachelor's in Nursing

Strumenti

Microsoft Office

Electronic Health Records

Descrizione del lavoro

Highmark Health is seeking a Case Manager to provide comprehensive case management services, assess member needs, and coordinate care plans to promote quality, cost-effective outcomes.

The role involves collaborating with physicians and the health care team, monitoring progress, and ensuring compliance with HIPAA and company policies. Strong clinical knowledge and licensure are required.