[Hiring] Case Manager RN @Highmark Health

Role Description

This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal health outcomes. The Case Manager assesses member needs, develops and implements care plans, coordinates services, and monitors progress, while containing the cost of health care services. The incumbent will assist in containing the cost of health care services by detecting, resolving and preventing improper utilization of member benefits.

Qualifications

• High School Diploma/GED (Required)
• Bachelor's Degree in Nursing (Preferred)

Requirements

• 3 years in any combination of clinical, case/utilization management, and/or disease condition management experience, or provider operations and/or health insurance experience (Required)
• Experience working with the healthcare needs of diverse populations (Preferred)
• Experience demonstrating understanding of the importance of cultural competency in addressing targeted populations (Preferred)
• Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or NY (Required)
• Other RN license(s), if applicable, must be obtained within the first 6 months of employment (Required)

Benefits

• Pay Range Minimum: $72,700.00
• Pay Range Maximum: $116,600.00

Company Description

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.