Care Manager RN – Utilization Management
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Job Description
Care Manager RN implementing effective utilization management strategies for Highmark Health. Educating providers, analyzing data, and resolving quality issues in Pennsylvania remote setting.
Responsibilities:
- Implement effective utilization management strategies
- Review appropriateness of health care services
- Educate providers and members
- Analyze qualitative and quantitative data
- Respond to customer inquiries
Requirements:
- 3 years of related, progressive clinical experience in the area of specialization
- Experience in a clinical setting
- Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC)
- Certification in utilization management or a related field (preferred)
Benefits:
- Health insurance
- 401(k) matching
- Flexible work arrangements
- Professional development
- Paid time off
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