Nurse Care Manager I - Anthem, Inc (California)
Description
SHIFT: Day Job
SCHEDULE: Full-time
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater 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 Care Manager I
Must live within 1 hour of an Anthem office
Hours: between the hours of 10:00 am - 7:30 pm (depending on time zone)
Responsible for performing telephonic 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 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.
+ Assists in problem solving with providers, claims or service issues.
Qualifications
+ 3 years of clinical RN experience (acute care desired - ER, ICU, Med/Surg)
+ Current, unrestricted RN license in applicable state(s) required.
+ Multi-state licensure is required if this individual is providing services in multiple states.
+ Experience with electronic documentation
+ Knowledge and work experience with Microsoft Office (Excel and Outlook)
+ Must be able to multi-task - talking and typing simultaneously
+ Experience using pc's with multiple screens
+ Bilingual a plus.
+ Ability to type 45 wpm with minimal errors.
+ Certification as a Case manager is preferred.
+ Experience with Managed Care and Medicare a plus.
+ Telephonic Case Management a plus.
+ BA/BS in a health related field; or any combination of education and experience, which would provide an equivalent background.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
REQNUMBER: PS49960
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