Senior RN Case Manager – Remote Care Advocate

Highmark Health; East Honolulu (HI); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services aimed at quality, cost-effective care and optimal health outcomes.

You will assess member needs, develop and implement care plans, coordinate services, and monitor progress while containing healthcare costs. The role requires a strong clinical background with case/utilization management experience and an RN or equivalent licensure, CCM certification within 36 months of hire, and the ability to work in an

Qualifications

• 5 years in clinical, case/utilization management, or disease condition management experience.
• RN licensure or multi-state licensure via eNLC.
• CCM certification must be obtained within 36 months of hire (incumbents as of Aug 2026 exempt).
• Experience with diverse populations and culture competency is preferred.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Assess health status, needs, and resources of members.
• Collaborate with members, physicians, and providers to develop care plans.
• Coordinate and access services; monitor progress toward goals.

Skills

Clinical assessment

Care planning

Leadership & mentoring

Negotiation & advocacy

EHR / EMR systems

Education

High School/GED

Bachelor of Nursing

Tools

Microsoft Office

Case management software

Electronic Health Records

Job description

Highmark Inc. is seeking a Case Manager to provide comprehensive case management services aimed at quality, cost-effective care and optimal health outcomes.

You will assess member needs, develop and implement care plans, coordinate services, and monitor progress while containing healthcare costs. The role requires a strong clinical background with case/utilization management experience and an RN or equivalent licensure, CCM certification within 36 months of hire, and the ability to work in an