Senior RN Case Manager — Remote Care Advocate

Highmark Health; North Carolina; Remote; USD 114,000 - 140,000; Full time

Job summary

Highmark Health seeks a seasoned Case Manager to deliver comprehensive case management for diverse members, assess needs, coordinate services, and develop individualized care plans that promote quality, cost-effective care, and optimal health outcomes.

You will monitor progress, adjust plans as needed, mentor junior Case Managers, collaborate with physicians and providers, and ensure documentation and compliance with HIPAA, policies, and accreditation standards.

Qualifications

• Experience with CBT, motivational interviewing or DBT.
• Bachelor's in Nursing and active RN licensure.
• Proficiency with case management software and EHR systems.
• Strong understanding 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.
• Assess health status, needs and resources; coordinate care services.
• Implement, monitor and adjust care plans; ensure access to services.
• Document activities in compliance with policies and accreditation standards.
• Provide guidance and mentorship to lower-level Case Managers.

Skills

CBT

Motivational interviewing

DBT

Microsoft Office

EHRs

Education

Bachelors in Nursing

Tools

Case management software

Electronic Health Records (EHR)

Job description

Highmark Health seeks a seasoned Case Manager to deliver comprehensive case management for diverse members, assess needs, coordinate services, and develop individualized care plans that promote quality, cost-effective care, and optimal health outcomes.

You will monitor progress, adjust plans as needed, mentor junior Case Managers, collaborate with physicians and providers, and ensure documentation and compliance with HIPAA, policies, and accreditation standards.