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Hours Full-time, Part-time
Location Falls Church, VA
Falls Church, Virginia

About this job

Description

$3000 Sign on bonus! IDD/DD RN Nurse Case Manager Teleworker - Virginia, all regions

We have multiple IDD/DD telephonic Nurse Case Manager positions supporting our LTSS (Long Term Services and Support) members in all regions of Virginia. You will be working from a home office as a telephonic case manager. At times there will be a need to meet with a member face to face. You must be able to travel locally at times to meet with members at a hospital for discharge planning or where they live (mileage, tolls reimbursed). You must have the flexibility to come into the office for meetings as needed. Computer related equipment for a home office will be provided. You must have a high speed data connection and land line (or VOIP line).

#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 Nurse Case Manager you will be responsible for performing care management within the scope of licensure for members with complex and chronic 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 on-site such as at hospitals for discharge planning.

* As the RN Clinician you are responsible for ensuring member access to services appropriate to their health needs.

* You conduct assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. This includes outreach to community resources and working with special needs and behavioral needs specialists in the region.

* You would implement care plans by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.

* As the Nurse Clinician you coordinate internal and external resources to meet identified needs.

* You, the RN Clinician will monitor and evaluate effectiveness of the care management plan and modifies as necessary.

* You will interface with Medical Directors and Physician Advisors on the development of care management treatment plans.

* You may also negotiate rates of reimbursement, as applicable.

* Additionally as the Nurse Clinician you may assist in problem solving with providers, claims or service issues.

Qualifications

This position may be hired at a level I or II depending upon the background, skills and experience of the chosen candidates.

You must be an RN.

* You must have a minimum of 3 years of clinical experience and experience 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 have experience working with the IDD/DD population, waiver programs and community resource groups.

* 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:

* Masters degree

* Certification as a Case Manager (CCM)

* 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 fall, including paid training

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

* A screening will occur via video or phone

* Live interview(s) 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 in advance for applying to Anthem! We have many openings in these territories so why not refer a friend? If you both 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.