Nurse Case Mgr I - Model of Care - PS20580 **Location:** **United States** **New** **Requisition #:** PS20580 **Post Date:** 6 days ago _Your Talent. OurVision._ **AtAnthem, Inc.,** its a powerful combination, and the foundation upon which were 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. **Nurse Case Manager I** **Preferred locations: CA, TX, OH, TN, KY, MO, CT, ME, NJ,NY** **, VA, IN, GA** **Open to US locations as well** **Must live within 60 miles or 1 hour of local office** **Hours: Any shift between 9:00 am - 7:00 pm EST** **(depending on time zone)** **Nurse Case Manager I - Model of Care -** Responsible for performing 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 healthneeds. + Conducts assessments to identify individual needs and a specific caremanagement plan to address objectives and goals as identified duringassessment. + Implements care plan by facilitating authorizations/referrals asappropriate within benefits structure or through extra-contractualarrangements. + Coordinates internal and external resources to meet identifiedneeds. + Monitors and evaluates effectiveness of the care management plan andmodifies as necessary. + Interfaces with Medical Directors and Physician Advisors on thedevelopment of care management treatment plans. + Assists in problem solving with providers, claims or serviceissues. This position will allow you the flexibility to work from home anywhere within US, see above preferred locations. You must reside within 60 miles to any Anthem office in the US, you must be available to go to office for training, technical computer issues, or if needed by needs of business. You must have a current unrestricted RN license. + 3 yearsof clinical RN experience (acute care desired - ER, ICU, Med/Surg) + Current,unrestricted RN license in applicable state(s) required. + Multi-statelicensure is required if this individual is providing services in multiplestates. + Experiencewith electronic documentation + Knowledge and work experience withMicrosoft Office (Excel and Outlook) + Must be able to multi-task - talking andtyping simultaneously + Experience using pc's with multiplescreens + Bilingual a plus. + Ability to type 50 wpm with minimalerrors. + Certification as a Case manager ispreferred. + Experience with Managed Care and Medicarea plus. + Telephonic Case Management aplus. + BA/BS in a health related field;or any combination of education and experience, which wouldprovide an equivalent background. **_Anthem, Inc. is ranked as one ofAmericas Most Admired Companies among health insurers by Fortune magazine andis a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn moreabout our company and apply, please visit us at antheminc.com/careers. An EqualOpportunity Employer/Disability/Veteran_** Associated topics: business development, case management, development, liaison, manage, office manager, plan, program development, project development, project management
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.