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RN Case Mgr I/II/Sr ($3000 Sign On-Bonus) (Atlanta Office-SHBP) 131265VMJ - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Atlanta, GA Atlanta, Georgia |
About this job
Description
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.
Nurse Case Manager I/II/Sr
$3000 Sign on Bonus
Location: Atlanta, GA office
Shifts: (Dependent upon business needs) Monday - Friday 10:00a to 6:30p or 10:30a to 7p
This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria.
Responsible for 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.
Primary duties may include, but are not limited to:
* Ensures member access to services appropriate to their healthcare needs.
* Works closely with members to conduct telephonic assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
* Demonstrates the ability to educate members on managing acute and chronic health conditions.
* Ability to coach members utilizing motivational interviewing skills.
* Implements care plan by facilitating referrals as appropriate within the benefit structure.
* Coordinates internal and external resources to meet identified needs such as Registered Dietitians, Exercise Physiologists, Social Workers and Respiratory Therapists (internally) and external vendor resources.
* Presents member cases in vendor rounds to show collaboration with the external vendors and interface with the client vendors and case management team.
* Monitors and evaluates effectiveness of the care management plan and works closely with the member and provider to modify as necessary.
* Provides close follow-up with the member appropriate to members' needs.
* 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.
* May assist with development of care management policies and procedures.
* Presents member cases in inter-disciplinary Medical Rounds in order to provide the highest level of service and the best care to the member.
Qualifications
Requires a BA/BS in a health related field; 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in State of GA required.
Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager is preferred.
Technical skills:
* Ability to talk and type at the same time.
* Demonstrate critical thinking skills when interacting with members.
* Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
* Ability to manage, review and respond to emails/instant messages in a timely fashion.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2016 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, 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.
Nurse Case Manager I/II/Sr
$3000 Sign on Bonus
Location: Atlanta, GA office
Shifts: (Dependent upon business needs) Monday - Friday 10:00a to 6:30p or 10:30a to 7p
This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria.
Responsible for 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.
Primary duties may include, but are not limited to:
* Ensures member access to services appropriate to their healthcare needs.
* Works closely with members to conduct telephonic assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
* Demonstrates the ability to educate members on managing acute and chronic health conditions.
* Ability to coach members utilizing motivational interviewing skills.
* Implements care plan by facilitating referrals as appropriate within the benefit structure.
* Coordinates internal and external resources to meet identified needs such as Registered Dietitians, Exercise Physiologists, Social Workers and Respiratory Therapists (internally) and external vendor resources.
* Presents member cases in vendor rounds to show collaboration with the external vendors and interface with the client vendors and case management team.
* Monitors and evaluates effectiveness of the care management plan and works closely with the member and provider to modify as necessary.
* Provides close follow-up with the member appropriate to members' needs.
* 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.
* May assist with development of care management policies and procedures.
* Presents member cases in inter-disciplinary Medical Rounds in order to provide the highest level of service and the best care to the member.
Qualifications
Requires a BA/BS in a health related field; 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in State of GA required.
Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager is preferred.
Technical skills:
* Ability to talk and type at the same time.
* Demonstrate critical thinking skills when interacting with members.
* Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
* Ability to manage, review and respond to emails/instant messages in a timely fashion.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2016 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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