South Richmond Hill, NY, United States
Healthcare, Nursing, Case Management, Manager
Nurse Case Mgr I
Location: United States
Requisition #: PS30494
Post Date: 5 hours ago
Your Talent. Our Vision. At Anthem, 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.
Case Manager I
Work from home or in the West Des Moines office
Hours: 40 hours
a week , Monday-Friday between 8-6pm
TO BE CONSIDERED YOU MUST LIVE IN THE STATE OF IOWA
Responsible for performing case management telephonically 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.
Primaryduties may include, but are not limited to
Ensures member access to servicesappropriate to their health needs.
Conducts assessments to identifyindividual needs and a specific care management plan to address objectives andgoals as identified during assessment.
Implements care plan byfacilitating authorizations/referrals as appropriate within benefits structureor through extra-contractual arrangements.
Coordinates internal and externalresources to meet identified needs.
Monitors and evaluateseffectiveness of the care management plan and modifies as necessary.
Interfaces with Medical Directorsand Physician Advisors on the development of care management treatment plans.
Assists in problem solving withproviders, claims or service issues.
In person visits to members mightbe needed from time to time but this not a common occurrence at this time
Reside in the state of Iowa
Current,unrestricted RN license for the State of Iowa
RN diploma or Associate degree in nursing (ADN) or a Bachelor of science in nursing (BSN)
3 years of clinical experience
Anycombination of education and experience, which would provide an equivalentbackground could be considered.
Website : http://www.antheminc.com