Senior RN Case Manager & Care Coordinator (Remote)

Highmark Health; Missouri; Remote; USD 114.000 - 140.000; Vollzeit

Zusammenfassung

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, coordinate care, and monitor outcomes while containing costs. You will assess needs, develop care plans, and collaborate with clinicians to optimize health outcomes.

The role requires 5+ years in clinical or utilization management, an active RN license, and CCM certification within 36 months of hire. Office-based with potential remote options in a dynamic healthcare team.

Qualifikationen

• 5+ years of combined clinical, case/utilization management, and/or health insurance experience.
• Experience with diverse populations and complex health needs.
• Strong training in CBT, motivational interviewing, or DBT.
• Proficiency with MS Office and EHR/case management software.
• Bachelors in Nursing with active RN licensure.

Aufgaben

• Manage a caseload of members with complex health needs requiring advanced clinical knowledge.
• Conduct comprehensive assessments and develop complex care plans.
• Coordinate services and monitor progress toward goals.
• Document activities in compliance with policies and regulations.
• Provide guidance and mentorship to lower-level Case Managers.
• Collaborate with physicians and providers to implement and adjust the plan of care.

Kenntnisse

CBT

Motivational interviewing

DBT

Clinical assessment

Care planning

EHR systems

Case management software

Microsoft Office

Ausbildung

Bachelor of Science in Nursing

Tools

Case management software

Electronic Health Records

Microsoft Office Suite

Jobbeschreibung

Highmark Health is seeking a Case Manager to deliver comprehensive case management services, coordinate care, and monitor outcomes while containing costs. You will assess needs, develop care plans, and collaborate with clinicians to optimize health outcomes.

The role requires 5+ years in clinical or utilization management, an active RN license, and CCM certification within 36 months of hire. Office-based with potential remote options in a dynamic healthcare team.