Base: $68,400.00 - $105,900.00; bonus/equity: not ...
Remote
Implement care management review processes
Adhere to regulatory compliance
Analyze qualitative and quantitative data
Highmark Health is seeking a Care Manager RN for a remote position focused on implementing utilization management strategies and improving healthcare service delivery. The ideal candidate will have significant clinical experience, particularly in utilization management and care management, and must hold a current RN licensure
Job Summary
This job implements effective utilization management strategies including review of appropriateness of health care services and application of criteria to ensure appropriate resource utilization.
Essential responsibilities include implementing care management review processes consistent with industry standards, functioning in accordance with applicable laws, and promoting quality and efficiency in care management services.
The role requires analyzing qualitative and quantitative data to improve provider performance and member satisfaction, while responding to customer inquiries and offering interventions.
Matching Summary
Match Score: 85
Highmark Health is seeking a Care Manager RN for a remote position focused on implementing utilization management strategies and improving healthcare service delivery. The ideal candidate will have significant clinical experience, particularly in utilization management and care management, and must hold a current RN licensure.
Salary
Base: $68,400.00 - $105,900.00; Bonus/Equity: Not specified; Benefits: Not specified