Vacancy expired!
Nurse Case Mgr I/II - PS31075Location: United StatesNewRequisition #: PS31075Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundationupon which we’re creating greater care for our members, greater value for ourcustomers, and greater health for our communities. Join us and together wewill drive the future of health care .This is an exceptionalopportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50Company.Nurse Case Mgr I/IIHours: Monday through Friday 8:00AM until 5:30PMLocation: Remote but must reside within 40 miles of an Anthem, Inc. locationResponsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning.Primary duties may include, but are not limited to:-Ensures member access to services appropriate to their health needs.-Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.-Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.-Coordinates internal and external resources to meet identified needs.-Monitors and evaluates effectiveness of the care management plan and modifies as necessary.-Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.-Negotiates rates of reimbursement, as applicable.-Assists in problem solving with providers, claims or service issues.-Assists with development of utilization/care management policies and procedures.Nurse Case Mgr I:Requires a BA/BS in a health related field; 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager is preferred. Discharge Planning experience highly preferred.Nurse Case Mgr II:Requires a BA/BS in a health related field; 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager is preferred. Discharge planning experience highly preferred.Please note: Position will be filled at a level I/II based on manager discretion.Anthem, Inc. is ranked as one ofAmerica’s Most Admired Companies among health insurers by Fortune magazine andis a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn moreabout our company and apply, please visit us at careers.antheminc.com. An EqualOpportunity Employer/Disability/Veteran.
Vacancy expired!