Senior RN Case Manager – Remote Care Coordination Lead

Highmark Health; Manchester (NH); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management to members, assess needs, develop and implement care plans, and coordinate services while monitoring progress to contain health care costs.

The role requires 5 years in clinical/case management, RN licensure (state) or multi-state via eNLC, and CCM certification within 36 months. Travel <25%. Office-Based or Remote with occasional on-site work.

Qualifications

• 5 years in clinical, case/utilization management, and/or disease condition management.
• Current RN license (state) or multi-state via eNLC.
• CCM certification must be obtained within 36 months of hire, with August 2026 exemption for incumbents.

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop and implement comprehensive care plans.
• Coordinate services and monitor progress toward goals.
• Advocate for members and ensure cost-effective outcomes.
• Document activities per policies and HIPAA; mentor junior staff.

Skills

Clinical assessment

Care planning

Leadership

Negotiation

Advocacy

EHR proficiency

Microsoft Office

Education

High School/GED

Bachelor's in Nursing

Tools

Case management software

Electronic Health Records

Microsoft Office

Job description

Highmark Inc. is seeking an experienced Case Manager to provide comprehensive case management to members, assess needs, develop and implement care plans, and coordinate services while monitoring progress to contain health care costs.

The role requires 5 years in clinical/case management, RN licensure (state) or multi-state via eNLC, and CCM certification within 36 months. Travel <25%. Office-Based or Remote with occasional on-site work.