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Anthem, Inc Nurse Case Mgr II in Watertown, Massachusetts

Nurse Case Mgr II

Location: United States


Requisition #: PS30782

Post Date: 4 days ago

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 togetherwe 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 ManagerII

Location: Work from home

Must live within 60 miles of anAnthem office

Hours: Monday – Friday: 8 hours daily between- 9:00am to 7:00pm EST

The Nurse Case Manager II position is 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.

Primaryduties 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 planutilizing case management best practicesto 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 withtreating physicians, Anthem Medical Directors, internal and external partners on the development of collaborative care management treatment plans.

· Implements initiatives and work flow processes for areas of focus identified by accounts and Anthem management team.

· Current, unrestricted RN license for the state in which he/she resides

· Current, unrestricted compact RN license

· 2- 3 years of clinical nursing experience

· 2 years’ experience in Case Management for a managed care organization

· The ability to travel on occasion. – In first month upon hire, will need to travel to Wisconsin for training with the client. Then there will periodic travel to Wisconsin to meet with the client

· Telephonic Case Managementexperience

· Certification as a Case Manager is desired, if applicant does not hold the certification at time of hire, he/she will need to obtain within 1 year.

Anthem,Inc. is ranked as one of America’s Most Admired Companies among health insurersby Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company forDiversity. To learn more about our company and apply, please visit us An Equal Opportunity Employer/Disability/Veteran.