Job Details

ID #2292871
State Louisiana
City Metairie
Full-time
Salary USD TBD TBD
Source Anthem, Inc
Showed 2019-05-13
Date 2019-05-14
Deadline 2019-07-13
Category Et cetera
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Nurse Case Mgr I - Model of Care - PS20975

Louisiana, Metairie 00000 Metairie USA

Vacancy expired!

Nurse Case Mgr I - Model of Care - PS20975Location: United StatesNewField: MedicalRequisition #: PS20975Your Talent. OurVision. AtAnthem, Inc., 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 health care .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.Nurse Case Manager IPreferred locations: CA, TX, OH, TN, KY, MO, CT, ME, NJ,NY , VA, IN, GAOpen to US locations as wellMust live within 60 miles or 1 hour of local officeHours: Any shift between 9:00 am - 7:00 pm EST(depending on time zone)Nurse Case Manager I - Model of Care - Responsible for performing 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. Primary duties may

include, but are not limited to:

Ensures member access to services appropriate to their healthneeds.

Conducts assessments to identify individual needs and a specific caremanagement plan to address objectives and goals as identified duringassessment.

Implements care plan by facilitating authorizations/referrals asappropriate within benefits structure or through extra-contractualarrangements.

Coordinates internal and external resources to meet identifiedneeds.

Monitors and evaluates effectiveness of the care management plan andmodifies as necessary.

Interfaces with Medical Directors and Physician Advisors on thedevelopment of care management treatment plans.

Assists in problem solving with providers, claims or serviceissues.

This position will allow you the flexibility to work from home anywhere

within US, see above preferred locations. You must reside within 60 miles to

any Anthem office in the US, you must be available to go to office for training,

technical computer issues, or if needed by needs of business. You must have a

current unrestricted RN license.

3 yearsof clinical RN experience (acute care desired - ER, ICU, Med/Surg)

Current,unrestricted RN license in applicable state(s) required.

Multi-statelicensure is required if this individual is providing services in multiplestates.

Experiencewith electronic documentation

Knowledge and work experience withMicrosoft Office (Excel and Outlook)

Must be able to multi-task - talking andtyping simultaneously

Experience using pc's with multiplescreens

Bilingual a plus.

Ability to type 50 wpm with minimalerrors.

Certification as a Case manager ispreferred.

Experience with Managed Care and Medicarea plus.

Telephonic Case Management aplus.

BA/BS in a health related field;or any combination of education and experience, which wouldprovide an equivalent background.

Anthem, Inc. is ranked as one ofAmerica’s Most Admired Companies among health insurers by Fortune magazine andis a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn moreabout our company and apply, please visit us at antheminc.com/careers. An EqualOpportunity Employer/Disability/Veteran

Vacancy expired!

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