Medical Case Manager

Job not on LinkedIn

🕒 June 2

🔔 Pennsylvania, Virginia, +1 more states – Remote

🔔 Pennsylvania – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote

💵 $72.7k - $116.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Highmark Health

WebsiteLinkedInAll Job Openings

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

• Providing case mgmt in PA, DE and WV. • Assures that members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care. • Assists in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities necessary to facilitate member access to healthcare services. • Advocates for the most appropriate care plan using sound clinical judgment; accurate planning, and collaboration with internal and/or external customers and contacts. • Follows established regulatory guidelines, policies, and procedures in relation to member interventions and documentation of activities related to the member’s care and progress across the continuum of care.

🎯 Requirements

• Minimum Bachelor’s degree in nursing or RN certification in lieu of bachelor's degree or Master’s degree in Social Work, Counseling, Education, or related field and 3 years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. • OR Bachelor’s degree in Social Work with five years’ experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. • Preferred Experience working with high-risk pregnant women OR experience working with chronic condition adult populations OR experience with pediatrics • 3 years of experience in working in Acute Care/Managed Care/Medicaid and Medicare populations. • Bilingual English/Spanish language skills. • Case Management Certification

🏖️ Benefits

• Health insurance • 401(k) matching • Paid time off • Professional development opportunities • Flexible working arrangements