• Anthem
  • $121,395.00 -97,930.00/year*
  • Wilmington, DE
  • Healthcare - Nursing
  • Full-Time
  • 2101 Shallcross Ave

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Nurse Case Mgr I - Model of Care - PS20623
**Location:** **United States**
**Requisition #:** PS20623
**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
**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 oflocal office**
**Hours: Any shift between 9:00 am - 7:00 pmEST**
**(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:
+ Ensuresmember access to services appropriate to their health needs.
+ Conductsassessments to identify individual needs and a specific care managementplan to address objectives and goals as identified during assessment.
+ Implementscare plan by facilitating authorizations/referrals as appropriatewithin benefits structure or through extra-contractual arrangements.
+ Coordinatesinternal and external resources to meet identified needs.
+ Monitorsand evaluates effectiveness of the care management plan and modifies asnecessary.
+ Interfaceswith Medical Directors and Physician Advisors on the development of caremanagement treatment plans.
+ Assistsin problem solving with providers, claims or service issues.
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 years of clinical RNexperience (acute care desired - ER, ICU, Med/Surg)
+ Current, unrestricted RNlicense in applicable state(s) required.
+ Multi-state licensure is required if thisindividual 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 50 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.
**_Anthem, Inc. isranked as one of Americas Most Admired Companies among health insurers byFortune magazine and is a 2018 DiversityInc magazine Top 50 Company forDiversity. To learn more about our company and apply, please visit us atantheminc.com/careers. An Equal OpportunityEmployer/Disability/Veteran_**
Associated topics: business development, case manager, development, development manager, manage, office manager, plan, project, program management, 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.

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