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RN Service Coordinator Case Manager El Paso MMP 101362 - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | El Paso, Texas |
About this job
Job Description
Seeking passionate, caring, and skilled healthcare professionals to join our new and exciting Medicare-Medicaid Program (MMP) team at Amerigroup!
Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it's a powerful combination. It's 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: El Paso, Texas (Telecommuting)
RN Service Coordinator Case Manager (Nurse Case Manager)
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. Performs duties telephonically or face-to-face with members. Primary duties may include, but are not limited to: Ensures member access to services appropriate to their health needs. 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 effectiveness of the care management plan and modifies 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.
Qualifications
Requires a BA/BS in a health related field; 3 years of clinical experience (5 years for higher level); or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in Texas required. Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager is preferred. Travel required within assigned territory.
Preferred:
Health plan experience.
Discharge planning.
SNF (Skilled Nursing Facility)
Home health experience.
Please note: Position may be filled at level I, II, or Sr level. Manager will determine level based upon the selected applicant's skillset relative to the qualifications listed for this position.
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.
Seeking passionate, caring, and skilled healthcare professionals to join our new and exciting Medicare-Medicaid Program (MMP) team at Amerigroup!
Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it's a powerful combination. It's 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: El Paso, Texas (Telecommuting)
RN Service Coordinator Case Manager (Nurse Case Manager)
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. Performs duties telephonically or face-to-face with members. Primary duties may include, but are not limited to: Ensures member access to services appropriate to their health needs. 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 effectiveness of the care management plan and modifies 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.
Qualifications
Requires a BA/BS in a health related field; 3 years of clinical experience (5 years for higher level); or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in Texas required. Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager is preferred. Travel required within assigned territory.
Preferred:
Health plan experience.
Discharge planning.
SNF (Skilled Nursing Facility)
Home health experience.
Please note: Position may be filled at level I, II, or Sr level. Manager will determine level based upon the selected applicant's skillset relative to the qualifications listed for this position.
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.
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