Senior RN Case Manager – Remote Care Coordinator

Highmark Health; Denver (CO); Hybrid; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking an experienced Case Manager to deliver comprehensive care coordination for members with complex health needs in a Colorado setting.

You will assess needs, develop and monitor care plans, and collaborate with physicians and providers to ensure quality, cost-effective outcomes. Responsibilities include managing a caseload, coordinating services, mentoring junior staff, and documenting activities in compliance with HIPAA and organizational policies.

Qualifications

• 5 years in clinical, case/utilization management, and/or health insurance experience.
• Experience in case management and utilization management.
• Knowledge of healthcare delivery systems and population health concepts.

Responsibilities

• Manage a caseload of members with complex health needs.
• Coordinate services and monitor progress toward goals.
• Develop and implement individualized care plans with providers.

Skills

Clinical assessment

Care planning

Leadership & mentoring

Negotiation & advocacy

EHR/case mgmt software

Education

High School Diploma or GED

Bachelors in Nursing

Tools

Microsoft Office

Case management software

Electronic Health Records

Job description

Highmark Inc. is seeking an experienced Case Manager to deliver comprehensive care coordination for members with complex health needs in a Colorado setting.

You will assess needs, develop and monitor care plans, and collaborate with physicians and providers to ensure quality, cost-effective outcomes. Responsibilities include managing a caseload, coordinating services, mentoring junior staff, and documenting activities in compliance with HIPAA and organizational policies.