Senior RN Case Manager – Remote, Complex Care Advocate

Highmark Health; Austin (TX); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. in Austin, TX is seeking a Case Manager to provide comprehensive case management services to members, assess needs, develop and coordinate care plans, and monitor progress to promote quality, cost-effective outcomes.

Requires 5+ years of clinical/case management experience, RN licensure (state or eNLC), CCM certification within 36 months, strong documentation abilities, and collaboration with physicians and other providers.

Qualifications

• 5 years in any combination of clinical, case/utilization management, and/or disease condition management experience.
• RN licensure current in state or multi-state via eNLC; CCM certification must be obtained within 36 months of hire (exempt for current employees).
• Experience with diverse populations and CBT/CBT-related approaches is a plus.

Responsibilities

• Manage a caseload of members with complex health needs and coordinate care plans.
• Conduct comprehensive assessments and develop complex, individualized care plans.
• Collaborate with physicians and health care teams to implement the plan and monitor outcomes.
• Document activities in compliance with policies and regulatory requirements.
• Provide mentorship and guidance to lower-level Case Managers.

Skills

Caseload management

Care coordination

Clinical assessment

Documentation

EHR proficiency

Communication

Leadership

Education

High School/GED

Bachelor's in Nursing

Tools

Microsoft Office

Case management software

Electronic health records

Job description

Highmark Inc. in Austin, TX is seeking a Case Manager to provide comprehensive case management services to members, assess needs, develop and coordinate care plans, and monitor progress to promote quality, cost-effective outcomes.

Requires 5+ years of clinical/case management experience, RN licensure (state or eNLC), CCM certification within 36 months, strong documentation abilities, and collaboration with physicians and other providers.