Anthem, Inc. Hiring for Nurse Case Manager Job Family I, II, or Sr at Hamilton, New Jersey Full Time

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 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.

Nurse Case Manager Job Family I, II, or Sr Location: This position will be a remote work from home position Hours: M- F 8-5 EST Please Note: This position may be filled at either the I, II, or Sr level. The manager will determine the level based upon the selected applicant’s skillset relative to the qualifications listed for this position.

Responsible for 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 and ensuring member access to services appropriate to their health needs. Primary duties may include, but are not limited to: • Ensures members access to services appropriate to their health needs for the ER Diversion Program. • 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 the effectiveness of the care management plan and modifies it 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. • Performs duties telephonically for discharge planning. • Enter notes, into your computer, as you are speaking with our members.

Qualifications

Minimum Requirements Requires a BA/BS in a health-related field; 3 years of clinical experience for Level I; 5 years of clinical experience for Level II or Sr; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required

Preferred Qualifications 3+ years of Case Management experience is preferred. Discharge planning experience is preferred. Medicare and/or Medicaid experience is preferred. Managed Care/Health Industry experience is preferred. Case Manager certification is preferred. Bilingual preferred. ER experience is preferred Excellent communication and interpersonal skills preferred Computer proficiency with web-based and other applications (Microsoft Office, etc.) preferred 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: PS54947