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in Martinsville, VA

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Hours Full-time, Part-time
Location Martinsville, VA
Martinsville, Virginia

About this job

Description

RN (Registered Nurse) Field Service Coordinator Clinician (Teleworker) Roanoke, Alleghany, Lexington, Blacksburg, Radford and/or Martinsville 128950

This is a field position supporting our LTSS (Long Term Services and Support) members in the Roanoke/Alleghany, VA area and surrounding counties. You will be working from home or in the field (mileage reimbursed). There may be some overnight travel at the onset of the rollout to support the CCC+ program. You must have the flexibility to come into the office for meetings as needed. Related computer equipment for a home office will be provided. You must have a high speed data connection.

#JoinAnthem

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. Together we can drive the future of health care.

As the LTSS Svc Coord RN Clinician you will be responsible for overall management of members case within the scope of licensure; you may provide direction to non-RN clinicians participating in the members case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the members care plan to meet the members needs, with the goal of optimizing member health care across the care continuum.

* As the RN Clinician you are responsible for performing face-to-face clinical assessments for the identification, evaluation, coordination and management of members' needs, including physical health, behavioral health, social services and long term services and supports. You would identify members for high risk complications and coordinates care in conjunction with the member and the health care team

* You manage members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits

* You would obtain thorough and accurate member history to develop individual care plans

* As the Nurse Clinician you collaborate with the members, caregivers, family, natural supports, physicians to establish short and long term goals; identifies members that would benefit from an alternative level of care or other waiver programs

* You, the RN Clinician will have overall responsibility to develop the care plan for services for the member and ensures the members access to those services.

* You might assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible

* As the RN Clinician, you interface with Medical Directors, Physician Advisors and/or Inter-Disciplinary teams on the development of care management treatment plans

* You may also have the opportunity to assist in problem solving with providers, claims or service issues

* Additionally as the Nurse Clinician you may direct the work of other licensed professionals other than a Nurse, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the members care plan to meet the members needs

Qualifications

* You must be an RN

* You must have experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator role, Case Management role, or working with Medicaid, managed care and/or LTSS

* You must live in VA and have a current, unrestricted RN license in the state of Virginia

* You must be able to travel locally; this position requires a reliable vehicle, current auto insurance and clean driving record (mileage, tolls reimbursed)

* You must be competent in MS Office suite to include Word, Outlook and Excel, as well as be comfortable with computers in general (i.e. Apple products) since you will be entering assessments into an iPad and syncing the information with a laptop.

* Some overnight travel may be required.

Preferred qualifications include:

* Master's degree

* Knowledgeable of involuntary psychiatric admissions related to emergency custody orders and temporary detention orders

* Demonstrated ability to communicate with members who have complex medical needs and who may have communication barriers

* Clinical nursing experience with medically complex members dependent on life sustaining equipment

* Current or prior field/home health experience preferred

Here is the process:

* There are multiple openings; hire date is summer, including paid training

* Anthem's Talent Acquisition team will be screening resumes, quickly and often

* A screening will occur via video or phone

* Live interviews will be conducted

* Once an offer is extended, a background verification process occurs to include education, criminal, professional license and professional career experience

Thank you for applying! We have many openings in these territories so why not refer a friend? If and your friend are hired; you will receive a referral bonus. Get paid and work with friends!

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 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.