Senior RN Case Manager | Remote Care Advocate

Highmark Health; Madison (WI); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services, coordinating care plans and monitoring progress to promote quality, cost-effective health outcomes.

The role involves assessing member needs, collaborating with physicians and providers, and ensuring proper utilization of benefits. The position requires extensive clinical knowledge, leadership capabilities, and the ability to mentor junior staff while maintaining compliance with organizational policies and

Qualifications

• Educational requirements: High School/GED; Preferred: Bachelors in Nursing.
• Licenses: Current State RN licensure OR current multi-state licensure through eNLC.
• Certification: CCM certification must be obtained within 36 months of hire (exempt for incumbents as of Aug 2026).

Responsibilities

• Manage a caseload of members with complex health needs with advanced clinical knowledge.
• Conduct comprehensive assessments and develop and coordinate complex care plans.
• Assess health status, needs and available resources; collaborate with members, physicians and providers.
• Implement, coordinate and monitor care plans to ensure access to services and containment of costs.
• Document activities in compliance with policies and accreditation standards.
• Provide guidance and mentorship to lower-level Case Managers.

Education

High School/GED

Bachelors in Nursing

Job description

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services, coordinating care plans and monitoring progress to promote quality, cost-effective health outcomes.

The role involves assessing member needs, collaborating with physicians and providers, and ensuring proper utilization of benefits. The position requires extensive clinical knowledge, leadership capabilities, and the ability to mentor junior staff while maintaining compliance with organizational policies and