Senior RN Case Manager – Remote Care Planning & Advocacy

Highmark Health; Illinois; Hybrid; USD 114,000 - 140,000; Full time

Job summary

Highmark Health is seeking a Case Manager to provide comprehensive case management services to members, coordinating care, assessing needs, and developing care plans to promote quality and cost-effective outcomes.

This role requires 5+ years of clinical or utilization management experience, RN licensure, CBT/MI/DBT training, and proficiency with EHRs and case management software. You will mentor junior staff and collaborate across the care team.

Qualifications

• 5+ years in clinical, case/utilization management, or disease management.
• RN licensure in state or multi-state via eNLC.
• Experience with CBT/MI/DBT training preferred.
• Proficiency with EHR and care coordination tools.

Responsibilities

• Manage a caseload of members with complex health needs.
• Conduct comprehensive assessments and develop care plans.
• Coordinate services and monitor progress toward goals.
• Advocate for members and optimize cost-effective care.
• Document activities in line with policies and standards.
• Mentor and provide guidance to junior Case Managers.
• Collaborate with physicians and healthcare teams.

Skills

Clinical knowledge

CBT

Motivational interviewing

DBT

EHR proficiency

Case management software

Microsoft Office

Education

Bachelor of Science in Nursing

Tools

Case management software

Electronic Health Records

Microsoft Office

Job description

Highmark Health is seeking a Case Manager to provide comprehensive case management services to members, coordinating care, assessing needs, and developing care plans to promote quality and cost-effective outcomes.

This role requires 5+ years of clinical or utilization management experience, RN licensure, CBT/MI/DBT training, and proficiency with EHRs and case management software. You will mentor junior staff and collaborate across the care team.