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

Highmark Health; Baltimore (MD); Remote; USD 114,000 - 140,000; Full time

Job summary

Highmark Health is seeking a skilled Case Manager to provide comprehensive case management services to members, coordinating care plans and monitoring progress to promote quality, cost-effective outcomes. You will assess needs, collaborate with physicians and providers, ensure access to services, and document activities in compliance with HIPAA and company policies.

Requires RN licensure, CCM within 3 years, CBT/MI/DBT experience preferred, and proficiency with EHR/case-management software;

Qualifications

• RN licensure required
• CCM certification must be obtained within 36 months
• CBT/MI/DBT experience is preferred
• Proficient with EHR and case management software
• Strong collaboration with physicians and care team

Responsibilities

• Provide comprehensive case management to members
• Develop and monitor individualized care plans
• Coordinate services and provider communication
• Document activities per HIPAA and company policy
• Mentor lower-level case managers

Skills

Clinical assessment

Care coordination

Communication

EHR proficiency

Microsoft Office

Education

RN licensure

CCM certification within 36 months

eNLC multi-state licensure

BSN/Bachelor’s in Nursing

Tools

EHR systems

Case management software

Microsoft Office

Job description

Highmark Health is seeking a skilled Case Manager to provide comprehensive case management services to members, coordinating care plans and monitoring progress to promote quality, cost-effective outcomes. You will assess needs, collaborate with physicians and providers, ensure access to services, and document activities in compliance with HIPAA and company policies.

Requires RN licensure, CCM within 3 years, CBT/MI/DBT experience preferred, and proficiency with EHR/case-management software;