Description
SHIFT: Day Job
SCHEDULE: Full-time
Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
"Telephonic- Nurse Case Manager I/II (Job Family)
Location: Work@Home TX, VA, CT, GA, NY, MO, FL, NC, SC, TN
Hours: Monday - Friday between the hours of 8:30am to 8:00pm EST
This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria.
Focus: Prevention of 30 day readmissions (inpatient) and decrease frequent ER visits for non-urgent symptoms.
How you will make an impact
Responsible for performing care management with focus on preadmission counselling, inpatient advocacy and post discharge management of member within the scope of licensure for members with complex and chronic care needs. Required skill set to include case management best practices in assessment of member, discharge planning, development of goals, implementation, coordination of services and evaluation of care plans designed to optimize member health care across the care continuum. Strong knowledge base of diseases and critical thinking acumen. Utilization Management experience preferred.
Primary duties may include, but are not limited to:
Ensure and coordinates member access to internal and external 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.
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.
Qualifications
Nurse Case Mgr I
Minimum Requirements:
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 the state you reside.
Multistate licensure is required if this individual is providing services in multiple states.
Minimum 2 years "telephonic" Case Management experience with a Managed Care Company.
Minimum 2 years' experience in acute care setting.
Preferred Capabilities, Skills and Experiences:
Ability to work independently with minimal oversight post orientation.
Certification as a Case Manager.
Ability to talk and type at the same time.
Demonstrate critical thinking skills when interacting with members.
Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
Ability to manage, review and respond to emails/instant messages in a timely fashion.
Nurse Case Mgr II
Minimum Requirements:
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 the state you reside.
Multistate licensure is required if this individual is providing services in multiple states.
Minimum 2 years "telephonic" Case Management experience with a Managed Care Company.
Minimum 2 years' experience in acute care setting.
Preferred Capabilities, Skills and Experiences:
Ability to work independently with minimal oversight post orientation preferred.
Certification as a Case Manager.
Ability to talk and type at the same time.
Demonstrate critical thinking skills when interacting with members.
Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
Ability to manage, review and respond to emails/instant messages in a timely fashion.
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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.
REQNUMBER: PS71177-Virginia
