Senior RN Case Manager - Complex Care & Advocacy (Remote)

Highmark Health; California; Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services for members, coordinating care plans and resources while containing healthcare costs.

The role involves assessing member needs, developing and monitoring complex care plans with physicians and other providers, and mentoring junior staff while ensuring HIPAA compliance and quality outcomes.

Qualifications

• 5 years in clinical, case/utilization management, or disease condition management experience.
• Experience with coordinating complex care plans with physicians and providers.
• Strong knowledge of healthcare systems and case management principles.

Responsibilities

• Manage a caseload of members with complex health needs and advanced clinical knowledge.
• Conduct comprehensive assessments and develop complex care plans.
• Coordinate access to services and resources to meet member needs.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

EHR

Education

RN licensure

CCM certification

Bachelor’s in Nursing

Tools

Microsoft Suite

Case management software

Electronic health records

Job description

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management services for members, coordinating care plans and resources while containing healthcare costs.

The role involves assessing member needs, developing and monitoring complex care plans with physicians and other providers, and mentoring junior staff while ensuring HIPAA compliance and quality outcomes.