Senior RN Case Manager - Remote Care Coordinator

Highmark Health; Jackson (MS); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members, focusing on quality outcomes and cost-effective care delivery. You will assess needs, develop and implement care plans, coordinate services, and monitor progress, while containing utilization and costs.

The role requires extensive clinical expertise, strong leadership, and collaboration with physicians and care teams.

Qualifications

• 5 years in clinical, case/utilization management, disease condition management, or health insurance roles.
• RN licensure in state or multi-state via eNLC.
• CCM certification must be obtained within 36 months of hire (exempt for incumbents as of Aug 2026).
• Bachelor's in Nursing preferred.

Responsibilities

• Manage a caseload of members with complex health needs.
• Develop and coordinate individualized care plans with members and providers.
• Assess health status, needs and resources to inform care planning.
• Implement and monitor care plans and adjust as needed to achieve goals.
• Document activities in accordance with policies and accreditation standards.
• Provide mentorship to junior Case Managers.

Skills

Clinical assessment

Care planning

Leadership & mentoring

Advocacy & negotiation

EHR & case management software

Education

Bachelor's in Nursing

High School/GED

Tools

Microsoft Office

Case management software

Electronic Health Records (EHR)

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management services for members, focusing on quality outcomes and cost-effective care delivery. You will assess needs, develop and implement care plans, coordinate services, and monitor progress, while containing utilization and costs.

The role requires extensive clinical expertise, strong leadership, and collaboration with physicians and care teams.