Complex Case Manager Rn - Specialty Pediatrics (remote)
Highmark Health
Remote, United States
Base: $72,700.00 - $116,600.00; bonus/equity: not ...
7 years clinical or case management experience
Current pa rn licensure or enlc multi-state license
Panel oversight and health management assessment
The incumbent assesses health management needs of a specified panel of members using data analytics and clinical judgment
Job Summary
The incumbent assesses health management needs of a specified panel of members using data analytics and clinical judgment.
Responsibilities include developing care plans, encouraging behavior changes, and coordinating resources to help members achieve personal health goals.
The role requires maintaining quality outcomes and ensuring compliance with CMS, state, and accreditation standards.
Matching Summary
The incumbent assesses health management needs of a specified panel of members using data analytics and clinical judgment.
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 eNLC multi-state license
Panel oversight and health management assessment
Nice-to-have
Advanced training in cognitive behavioral therapy
Experience with diverse populations and cultural competency
Certification in Case Management (CCM)
Key Requirements
High School Diploma/GED required; Bachelor's Degree 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