Senior RN Case Manager - Remote Care Leader

Highmark Health; Colorado Springs (CO); Hybrid; USD 120,000 - 140,000; Full time

Job summary

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

The role requires collaboration with physicians and the health care team, documentation in line with HIPAA and policy standards, and mentoring of junior staff. Travel and remote options may apply.

Qualifications

• 5 years in clinical, case/utilization management or related field.
• Experience with diverse populations and health care needs.
• Advanced training in CBT, motivational interviewing, or DBT.

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 to promote cost-effective outcomes.
• Collaborate with physicians and care team to execute the plan.
• Document activities in compliance with policies and regulations.
• Provide guidance to lower-level Case Managers.

Skills

Case management

Clinical assessment

Care planning

Communication

CBT/MI/DBT

Education

Bachelors in Nursing

RN licensure

CCM certification within 36 months

Tools

Microsoft Office

Electronic Health Records (EHR)

Case management software

Job description

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

The role requires collaboration with physicians and the health care team, documentation in line with HIPAA and policy standards, and mentoring of junior staff. Travel and remote options may apply.