Care Manager RN – Utilization Management

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🔥 3 minutes 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 effective utilization management strategies including review of appropriateness of health care services • Monitor and analyze the delivery of health care services • Educate providers and members on a proactive basis • Develop and sustain positive working relationships with internal and external customers

🎯 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.

🏖️ Benefits

• Health insurance • Paid time off • Flexible work arrangements

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