Anthem, Inc. Nurse Case Mgr I/II/Sr in Albany, New York
SHIFT: Day Job
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:
Hours: 8:00am - 4:30pm Monday through Friday with an occasional shift of 11:30am - 8:00pm per month.
Location: Temporarily remote but must be commutable to Albany office
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.
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 and implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extracontractual 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.
• Collaborates with the Multi-Disciplinary team to promote valued Member centric outcomes.
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 New York required. Multi-state licensure is required if this individual is providing services in multiple states.
Certification as a Case Manager is preferred.
You will receive training on Anthem specific applications, however, you must be comfortable working on a laptop with webbased applications. You must have experience working with MS Word, Outlook and Excel. If you are not computer savvy this may hinder your ability to be successful in this position.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com.
An Equal Opportunity Employer/Disability/Veteran.
We provide a comprehensive benefits package, including generous PTO, medical, dental and vision plans, 401(k) with a
match, education assistance, and much more. EOE Dedicated to diversity.