Complex Case Manager, RN – Specialty Pediatrics

Highmark Health

Complex Case Manager handling clinical interventions and care plans for pediatric patients. Collaborating with multidisciplinary teams in a remote capacity.

Posted 6/16/2026full-timeRemote • Louisiana, Maryland, North Carolina, Pennsylvania, Washington • 🇺🇸 United StatesSeniorLead💰 $72,700 - $116,600 per yearWebsite

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Hard Skills

case managementclinical interventionscare plansquality outcomes monitoringcognitive behavioral therapy (CBT)motivational interviewingdialectical behavior therapy (DBT)MS Excel

Soft Skills

collaborationoutreachassessment

Certifications & Qualifications

PA RN licensuremulti-state licensure through eNLCCertification in Case Management

Industry Keywords

health managementhealth insurancemulti-disciplinary teams

About the role

Key responsibilities & impact

Manage a panel of members with varying health management needs
Assess health management needs and determine appropriate clinical interventions
Develop care plans with short and long term goals
Monitor quality outcomes for case management
Conduct outreach to members enrolled in case management
Collaborate with multi-disciplinary teams to coordinate care

Requirements

What you’ll need

High School Diploma/GED required
7 years of clinical, case management, or health insurance experience required
Advanced training in cognitive behavioral therapy (CBT), motivational interviewing or dialectical behavior therapy (DBT) preferred
Current PA RN licensure OR multi-state licensure through eNLC preferred
Certification in Case Management preferred
Proficiency in MS Excel is required

Benefits

Comp & perks

Health insurance
401(k) plan
Paid time off
Flexible work arrangements
Professional development opportunities