Care Manager Rn - (remote)

Highmark Health

Base: $68,400.00 - $105,900.00; bonus/equity: not ...
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3 years progressive clinical experience
Current pa rn licensure or enlc
Review of healthcare service appropriateness
** Highmark Health is seeking a remote Care Manager RN to implement effective utilization management strategies, focusing on healthcare service appropriateness and quality improvement. The ideal candidate should have a clinical background with experience in utilization management or related fields. **

Job Summary

  • This role implements effective utilization management strategies including the review of appropriateness of health care services.
  • The incumbent is responsible for identifying opportunities for referral to a Health Coach and resolving quality issues.
  • Employees must adhere to HIPAA regulations and company policies regarding confidential customer information.

Matching Summary

Match Score: 75

** Highmark Health is seeking a remote Care Manager RN to implement effective utilization management strategies, focusing on healthcare service appropriateness and quality improvement. The ideal candidate should have a clinical background with experience in utilization management or related fields. **

Salary

Base: $68,400.00 - $105,900.00; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • 3 years progressive clinical experience
  • Current PA RN licensure or eNLC
  • Review of healthcare service appropriateness

Nice-to-have

  • Bachelor's Degree in Nursing
  • Certification in utilization management
  • Experience in UM/CM/QA/Managed Care

Key Requirements

  • 3 years related clinical experience
  • Current State of PA RN licensure
  • Multi-state licensure via eNLC

Work Rights

Not specified

Tailored Resume

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