Senior RN Case Manager – Remote, Complex Care & Advocacy

Highmark Health; New Hampshire; Hybride; USD 79 000 - 127 000; Plein temps

Résumé du poste

Highmark Health is seeking an experienced Case Manager to deliver comprehensive case management services for members, focusing on quality care delivery while controlling costs. The role involves assessing needs, developing and implementing care plans, coordinating services, and monitoring progress within contract benefits.

Responsibilities include managing a caseload, collaborating with physicians, documenting activities, and acting as a clinical expert and mentor to junior staff.

Qualifications

• Experience in clinical, case/utilization management, or disease condition management.
• Relevant nursing licensure and CCM certification preferred or required within set timeframe.

Responsabilités

• Manage a caseload of members with complex health needs.
• Develop and coordinate individualized care plans with clinicians and providers.
• Monitor progress and adjust plans to achieve outcomes and cost efficiency.
• Document activities in compliance with policies and regulations.

Connaissances

Clinical assessment

Care planning

Leadership

Negotiation

Advocacy

Formation

High School/GED

Bachelor's in Nursing

Outils

Microsoft Office

Case management software

Electronic health records

Description du poste

Highmark Health is seeking an experienced Case Manager to deliver comprehensive case management services for members, focusing on quality care delivery while controlling costs. The role involves assessing needs, developing and implementing care plans, coordinating services, and monitoring progress within contract benefits.

Responsibilities include managing a caseload, collaborating with physicians, documenting activities, and acting as a clinical expert and mentor to junior staff.