Senior RN Case Manager — Remote Care Leader

Highmark Health; Oklahoma City (OK); A distancia; USD 79.000 - 127.000; Jornada completa

Descripción de la vacante

Highmark Inc. is seeking a skilled Case Manager to provide comprehensive case management services, assess member needs, develop and coordinate complex care plans, and promote high-quality, cost-effective outcomes.

The role requires at least five years of clinical or utilization management experience, offers office-based or remote work, travel under 25%, and opportunities to mentor junior staff while ensuring HIPAA compliance and adherence to accreditation standards.

Formación

• Required five years in clinical, case/utilization management, or disease condition management, or provider operations/health insurance.
• Experience with transplant care and diverse populations is preferred.
• CBT/MI/DBT training is a plus.

Responsabilidades

• Provide comprehensive case management services and assess member needs.
• Develop, implement, and coordinate individualized care plans.
• Monitor progress and adjust plans to achieve desired outcomes.
• Ensure documentation complies with HIPAA, policies, and accreditation standards.

Conocimientos

Clinical assessment

Care planning

Advocacy

EHR proficiency

Educación

High School/GED

Bachelor's in Nursing

Herramientas

Case management software

Electronic health records

Descripción del empleo

Highmark Inc. is seeking a skilled Case Manager to provide comprehensive case management services, assess member needs, develop and coordinate complex care plans, and promote high-quality, cost-effective outcomes.

The role requires at least five years of clinical or utilization management experience, offers office-based or remote work, travel under 25%, and opportunities to mentor junior staff while ensuring HIPAA compliance and adherence to accreditation standards.