Senior Case Manager RN - Maternity/NICU (Remote)

**Company :**
Highmark Inc.
**Job Description :**

**JOB SUMMARY**

This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal health outcomes. The Case Manager assesses member needs, develops and implements care plans, coordinates services, and monitors progress, while containing the cost of health care services. The incumbent will assist in containing the cost of health care services by detecting, resolving and preventing improper utilization of member benefits.

**ESSENTIAL RESPONSIBILITIES**

+ Manage a caseload of members with complex health needs, requiring advanced clinical knowledge.
+ Conduct comprehensive assessments and develop complex care plans.
+ Assess members’ health status, needs, and available resources.
+ Develop individualized care plans in collaboration with members, physicians, and other healthcare providers.
+ Imple...