Senior RN Case Manager - Remote Care Coordination Leader

Highmark Health; Charlotte (NC); Remote; USD 114,000 - 140,000; Full time

Job summary

Highmark Health is seeking a skilled Case Manager to deliver comprehensive case management services aimed at quality and cost-effective care for members. You will assess needs, develop complex care plans, and coordinate services with healthcare teams to promote optimal outcomes.

The role requires an RN license (US) with 5 years of clinical/case management experience, advanced training in CBT/MI/DBT, and CCM certification within 36 months of hire.

Qualifications

• 5 years in clinical, case/utilization management, or disease management experience.
• Advanced training in CBT, motivational interviewing, or DBT.
• RN licensure in state or multi-state via eNLC; CCM certification within 36 months.

Responsibilities

• Provide comprehensive case management services to members to ensure quality, cost-effective care and optimal health outcomes.
• Assess needs, develop and implement complex care plans, coordinate services, and monitor progress to contain costs.
• Advocate for members and coordinate with physicians and healthcare providers; document activities per policies and accreditation standards.

Skills

Clinical experience

Care planning

Communication

Advocacy

Education

BSN (Bachelor of Science in Nursing)

Tools

Microsoft Office

EHR

Case management software

Job description

Highmark Health is seeking a skilled Case Manager to deliver comprehensive case management services aimed at quality and cost-effective care for members. You will assess needs, develop complex care plans, and coordinate services with healthcare teams to promote optimal outcomes.

The role requires an RN license (US) with 5 years of clinical/case management experience, advanced training in CBT/MI/DBT, and CCM certification within 36 months of hire.