Senior RN Case Manager — Remote Patient Advocate

Highmark Health; Juneau (AK); Remote; USD 79,000 - 127,000; Full time

Job summary

Highmark Inc. in the United States is seeking a Case Manager to provide comprehensive case management services, assess member needs, develop and implement care plans, coordinate services, and monitor progress to promote quality, cost-effective outcomes.

The role requires 5 years of experience in clinical, case/utilization management, or related health insurance fields; RN licensure or eNLC, and CCM certification within 36 months of hire. Office-based or remote work with travel <25% is available.

Qualifications

• 5 years in clinical, case/utilization management, disease condition management or related health insurance operations.
• RN licensure or multi-state licensure via eNLC is required.
• CCM certification must be obtained within 36 months of hire (exempt for incumbents as of Aug 2026).
• Experience with diverse populations and CBT/CBT related trainings are preferred.

Responsibilities

• Manage a caseload of members with complex health needs and advanced clinical knowledge.
• Conduct comprehensive assessments and develop complex care plans.
• Coordinate services and monitor progress toward goals.
• Advocate for members and collaborate with physicians and healthcare providers.

Skills

Clinical assessment

Care planning

Leadership

Negotiation

EHR / MS Office

Education

High School/GED

Bachelors in Nursing

Tools

Case management software

Electronic health records

Microsoft Office

Job description

Highmark Inc. in the United States is seeking a Case Manager to provide comprehensive case management services, assess member needs, develop and implement care plans, coordinate services, and monitor progress to promote quality, cost-effective outcomes.

The role requires 5 years of experience in clinical, case/utilization management, or related health insurance fields; RN licensure or eNLC, and CCM certification within 36 months of hire. Office-based or remote work with travel <25% is available.