Job Details

ID #5090780
State Connecticut
City Wallingford
Full-time
Salary USD TBD TBD
Source Anthem, Inc.
Showed 2020-10-20
Date 2020-10-21
Deadline 2020-12-19
Category Et cetera
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(Bilingual) RN Nurse Case Mgr I, Obstetrics (Remote)

Connecticut, Wallingford 00000 Wallingford USA

Vacancy expired!

Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Empire Blue Cross Blue Shield, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of healthcare. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.LOCATION: This is a remote from home position servicing our New York Medicaid members. New York licensure is required.HOURS: 8:00a - 5:00p, EST.The Bilingual OB RN Nurse Case Manager is responsible for performing care management within the scope of licensure for high risk and obstetric 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 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.

May negotiate rates of reimbursement, as applicable.

Qualifications Requires current, active, unrestricted RN license from the state of New York.

BA/BS in a health related field; 3 years of clinical experience, or any combination of education and obstetric experience, which would provide an equivalent background, is required.

Case Manager experience is strongly preferred.

High risk obstetrics/antepartum experience is strongly preferred.

Bilingual English-Spanish skills are required.

Certification as a Case Manager (CCM) is preferred.

You must be competent in Microsoft Word, Excel, and Outlook.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2019 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at antheminc.com/careers.AnEqualOpportunityEmployer/Disability/VeteranREQNUMBER: PS39849-Connecticut

Vacancy expired!

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