Job Details

ID #3224243
State Michigan
City Dearborn
Full-time
Salary USD TBD TBD
Source Anthem, Inc.
Showed 2020-01-16
Date 2020-01-17
Deadline 2020-03-17
Category Et cetera
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Physical Health Manager I - HCMS - PS32427

Michigan, Dearborn 00000 Dearborn USA

Vacancy expired!

Physical Health Manager I - HCMS - PS32427Location: United StatesNewRequisition #: PS32427Your 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.Manager I - HCMS - PS32427Location: Remote - Must reside within 60 miles of an Anthem, Inc. office locationHours: 8:00AM until 5:00PMCentral Time Zone preferredResponsible for managing a team of physical and/or behavioral health practitioners responsible for coordinating member service, utilization, access, care management and/or concurrent review to ensure cost effective utilization of health, mental health, and substance abuse services for one or more member product populations of varying medical complexity ensuring the delivery of essential services that address the total healthcare needs of members.Primary duties may include, but are not limited to:

Manages and oversees team responsible in case finding and coordinating cases that involve comorbid conditions.

Coordinates service delivery to include member assessment of physical and psychological factors.

Partners with providers to establish short and long term goals that meet the members needs, functional abilities, and referral sources requirements.

Identifies members with potential for high risk complications.

Reviews benefit systems and cost benefit analysis.

Evaluates medical, mental health and substance abuse service for cost containment.

Supports program compliance and assists in identifying opportunities to improve the customer service and quality outcomes.

Supports quality initiatives and activities, including adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting.

Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Requires a BA/BS; 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background.

Current active unrestricted RN

Certified Case Manager Certification preferred.

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

Vacancy expired!

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