Care Manager, RN

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🔥 1 minute ago

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Logo of Highmark Health

Highmark Health

10,000+ employees

Founded 1852

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

💰 $5M Grant on 2021-05

Healthcare Insurance • Non-profit • Social Impact

Highmark Health is a healthcare company committed to reinventing the healthcare system and improving its services for everyone. The organization offers a broad range of career opportunities across various fields such as clinical care, technology, finance, and marketing. Highmark Health emphasizes diversity, equity, and inclusion in its workforce, creating a supportive environment for employees from all backgrounds. The company has been recognized for its commitment to disability inclusion, diversity, and military-friendly employment. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Health strives to create remarkable healthcare experiences for its customers and employees alike.

📋 Description

• Implement care management review processes that are consistent with established industry and corporate standards • Function in accordance with applicable state, federal laws and regulatory compliance • Promote quality and efficiency in the delivery of care management services • Identify and refer members whose healthcare outcomes might be enhanced by Health Coaching/case management interventions

🎯 Requirements

• 3 years of related, progressive clinical experience in the area of specialization • Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). • Certification in utilization management or a related field (preferred) • Working knowledge of pertinent regulatory and compliance guidelines and medical policies • Ability to analyze data, measure outcomes, and develop action plans

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements

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