Senior RN Case Manager - Remote Care Coordinator

Highmark Health; Lansing (MI); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services to members, develop and implement care plans, and coordinate services to ensure quality, cost-effective care.

The role requires an RN license, CCM certification within 36 months, and 5 years of related experience. You will mentor junior staff and ensure documentation complies with HIPAA and company policies.

Qualifications

• 5 years in clinical, case/utilization management, or disease management.
• RN licensure in state or multi-state eNLC.
• CCM certification must be obtained within 36 months.
• Preferred: transplant-specific clinical experience
• Preferred: experience with diverse populations
• Preferred: CBT/MBT/DBT training

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop complex care plans.
• Coordinate services and monitor progress toward goals.
• Advocate and liaison to meet members' health care needs.
• Document activities in compliance with policies and regulations.

Skills

Clinical assessment

Care planning

Leadership

Advocacy

Microsoft Office & EHR

Education

High School/GED

Bachelors in Nursing

Tools

Case management software

Electronic Health Records (EHR)

Microsoft Office

Job description

Highmark Inc. is seeking a Case Manager to deliver comprehensive case management services to members, develop and implement care plans, and coordinate services to ensure quality, cost-effective care.

The role requires an RN license, CCM certification within 36 months, and 5 years of related experience. You will mentor junior staff and ensure documentation complies with HIPAA and company policies.