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Lead, Case Manager (LVN/RN required) - Richmond, VA
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | richmond, Virginia |
About this job
Description
Your Talent. Our Vision. At CareMore , a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, 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.
Responsible for managing quality, cost effective care using selective benefits and alternative services best suited for the member and serving as a lead for case management staff. Primary duties may include, but are not limited to: Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs. Supports member or their representative in regard to care, care transitions, and changes in health status. Implements a comprehensive clinical case management plan for each patient. Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed. Analyzes patient variances from the plan and initiates the appropriate steps to resolve variances. Develops and implements discharge planning for patients in conjunction with hospital based case managers. Provides direction to case management staff and resolves issues. Utilizes clinical reports and audits. Assures appeals and grievances are processed timely and accurately. Serves as subject matter expert on patient care coordination. Assures documentation and process compliance.
Qualifications
Requires a LVN, LPN, or RN; 4 years of experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted LVN, LPN, or RN license in applicable state(s) required.
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 CareMore , a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, 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.
Responsible for managing quality, cost effective care using selective benefits and alternative services best suited for the member and serving as a lead for case management staff. Primary duties may include, but are not limited to: Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs. Supports member or their representative in regard to care, care transitions, and changes in health status. Implements a comprehensive clinical case management plan for each patient. Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed. Analyzes patient variances from the plan and initiates the appropriate steps to resolve variances. Develops and implements discharge planning for patients in conjunction with hospital based case managers. Provides direction to case management staff and resolves issues. Utilizes clinical reports and audits. Assures appeals and grievances are processed timely and accurately. Serves as subject matter expert on patient care coordination. Assures documentation and process compliance.
Qualifications
Requires a LVN, LPN, or RN; 4 years of experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted LVN, LPN, or RN license in applicable state(s) required.
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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