Care Manager RN - Weekend (FT) Remote

📋 Description

• • The Care Manager RN - Weekend (FT) Remote role at Highmark Health is a critical position focused on implementing utilization management strategies to ensure appropriate healthcare resource use, improve provider and member satisfaction, and identify opportunities for care coordination and quality improvement.
• • Day to day, the RN will review the appropriateness of healthcare services, apply clinical criteria, identify members for Health Coaching or case management referral, analyze qualitative and quantitative data, educate providers and members, respond to customer inquiries, and collaborate with internal and external stakeholders to enhance care outcomes and streamline processes.
• • Highmark Health is a leading integrated health and wellness organization dedicated to improving access, affordability, and quality of care for its members. The Care Management team operates within a mission-driven culture that values innovation, collaboration, and evidence-based practices to drive better health outcomes across Pennsylvania and beyond.
• • In this role, the RN will develop expertise in utilization management, case management, and quality assurance while strengthening clinical judgment, data analysis, communication, and relationship-building skills. The position offers opportunities to influence care delivery systems, contribute to performance improvement initiatives, and grow professionally within a nationally recognized healthcare organization.