The job below is no longer available.
You might also like
in Zenia, CA
California Department of Corrections and Rehabilitation • 13h agoJust posted Urgently hiring 28 mi Use left and right arrow keys to navigate- $2,075
Verified per week PHP • 3d agoUrgently hiring 49.4 mi Use left and right arrow keys to navigate - $2,087
Verified per week PHP • 3d agoUrgently hiring 49.4 mi Use left and right arrow keys to navigate - $64
est. per hour Adventist Health • 5d agoUrgently hiring 49.4 mi Use left and right arrow keys to navigate - $64
est. per hour Adventist Health • 5d agoUrgently hiring 49.4 mi Use left and right arrow keys to navigate
Nurse Care Mgr I/II/Sr - Telecommute - Anywhere in CA - 113821
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Zenia, California |
About this job
Description
Your Talent. Our Vision. At Anthem Blue Cross , a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater 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.
Location: This position can be located anywhere in California and offers instant telecommute.
Responsible for collaborating with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs care management activities within the scope of licensure for members with complex and chronic care needs. Primary duties may include, but are not limited to:
Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of network services, and appropriateness of treatment setting and level of care.
Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance. Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge.
Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Qualifications
Requires 3 years of acute care clinical experience; 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 if this individual is providing services in multiple states.
Home health/discharge planning experience preferred.
AS/BS in nursing preferred.
Certification as a Case Manager is preferred.
For URAC accredited areas, the following applies:
Current and active RN license required in applicable state(s) that allows for an independent assessment to be conducted within their scope of practice. Requires
3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background, Multi-state licensure is required if this individual is providing services in multiple states.
Certification as a Case Manager from the approved list of certifications or a BS in a health or human services related field also preferred.
***May be hired as a Nurse Care Manager I/II/Sr depending upon level of education and relevant experience.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.
Your Talent. Our Vision. At Anthem Blue Cross , a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater 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.
Location: This position can be located anywhere in California and offers instant telecommute.
Responsible for collaborating with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs care management activities within the scope of licensure for members with complex and chronic care needs. Primary duties may include, but are not limited to:
Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of network services, and appropriateness of treatment setting and level of care.
Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance. Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge.
Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Qualifications
Requires 3 years of acute care clinical experience; 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 if this individual is providing services in multiple states.
Home health/discharge planning experience preferred.
AS/BS in nursing preferred.
Certification as a Case Manager is preferred.
For URAC accredited areas, the following applies:
Current and active RN license required in applicable state(s) that allows for an independent assessment to be conducted within their scope of practice. Requires
3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background, Multi-state licensure is required if this individual is providing services in multiple states.
Certification as a Case Manager from the approved list of certifications or a BS in a health or human services related field also preferred.
***May be hired as a Nurse Care Manager I/II/Sr depending upon level of education and relevant experience.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.
Your Privacy Choices