Complex Case Manager Rn - Remote

Highmark Health

Remote, US
Base: $72,700.00 - $116,600.00; bonus/equity: not ...
7 years clinical or case management experience
Current pa rn licensure or multi-state enlc
Proficiency in ms excel and data analytics
The incumbent assesses health management needs of an assigned member panel using data analytics and professional clinical judgment to identify appropriate interventions

Job Summary

  • The incumbent assesses health management needs of an assigned member panel using data analytics and professional clinical judgment to identify appropriate interventions.
  • Responsibilities include developing care plans, encouraging behavior changes, identifying barriers to care, and coordinating resources to help members achieve personal health goals.
  • The role requires maintaining oversight of a specified panel while ensuring compliance with CMS, state, and accreditation standards to improve clinical, financial, and functional outcomes.

Matching Summary

The incumbent assesses health management needs of an assigned member panel using data analytics and professional clinical judgment to identify appropriate interventions.

Salary

Base: $72,700.00 - $116,600.00; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • 7 years clinical or case management experience
  • Current PA RN licensure or multi-state eNLC
  • Proficiency in MS Excel and data analytics
  • Ability to develop comprehensive care plans
  • Knowledge of CMS and regulatory standards

Nice-to-have

  • Advanced training in cognitive behavioral therapy
  • Experience with diverse population healthcare needs
  • Understanding of cultural competency principles
  • Certification in Case Management preferred
  • Motivational interviewing skills

Key Requirements

  • High School Diploma/GED required; Bachelor's in Nursing preferred
  • 7 years of clinical, case management, or disease management experience
  • Current State of PA RN licensure or multi-state eNLC/WV/DE/NY license
  • Must obtain other RN licenses within first 6 months if applicable

Work Rights

Not specified

Tailored Resume

Cover Letter