Complex Case Manager, RN

Highmark Health

Complex Case Manager RN responsible for managing health status of members with clinical needs. Assessing needs, coordinating care, and improving health outcomes using analytics and judgment.

Posted 5/20/2026full-timeRemote • Louisiana, Maryland, North Carolina, Pennsylvania, Washington • 🇺🇸 United StatesSeniorLead💰 $72,700 - $116,600 per yearWebsite

About the role

Key responsibilities & impact

Assess health management needs of assigned member panel
Utilize data/analytics and clinical judgment to identify right interventions
Create care plans and manage case load of members
Conduct outreach to members for care coordination
Monitor and improve quality outcomes for members

Requirements

What you’ll need

High School Diploma/GED
7 years of any combination of clinical, case management and/or disease/condition management experience
Current State of PA RN licensure OR Current multi-state licensure through eNLC or WV or DE or NY
Certification in Case Management (Preferred)
Advanced training and experience in cognitive behavioral therapy (CBT), motivational interviewing or dialectical behavior therapy (DBT) (Preferred)

Benefits

Comp & perks

Health insurance
401(k) matching
Paid time off
Remote work options

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

case managementdisease managementcare coordinationcognitive behavioral therapymotivational interviewingdialectical behavior therapy

Soft Skills

clinical judgmentoutreachquality improvement

Certifications

RN licensureCertification in Case Management