Nurse Case Mgr I

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POST DATE 1/26/2020
END DATE 1/27/2020

Anthem, Inc Montebello, CA

Montebello, CA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)


Nurse Case Mgr I
**Location:** **United States**
**Requisition #:** PS31624
**Post Date:** 3 days ago
_Your Talent. Our Vision._ **At Anthem, Inc.,** it s a powerful combination, and 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 at
one of America's leading health benefits companies and a Fortune Top 50
**NurseCase Manager I**
Work from Home position
**Hours:** Any shift between 9:30 am 6:30 pm EST _(Depending on time zone)_
**Preferredlocations:** CA, TX, OH, TN, KY, MO, CT, ME, NJ, NY **, VA, IN, GA**
Open to other US locations as well
Must live within 60 miles or 1 hour of local office
Start Date: **Monday March 2, 2020**
**Nurse Case Manager I - Model of Care** Responsible for performing care
management telephonically 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. Primary duties may include, but are not
limited to:
+ Ensures member access toservices appropriate to their health needs.
+ Conducts assessments toidentify individual needs and a specific care management plan to addressobjectives and goals as identified during assessment.
+ Implements care plan byfacilitating authorizations/referrals as appropriate within benefitsstructure or through extra-contractual arrangements.
+ Coordinates internal andexternal resources to meet identified needs.
+ Monitors and evaluateseffectiveness of the care management plan and modifies as necessary.
+ Interfaces with MedicalDirectors and Physician Advisors on the development of care managementtreatment plans.
+ Assists in problemsolving with providers, claims or service issues.
position will allow you the flexibility to work from home anywhere within US,
see above preferred locations. You must reside within 60 miles to any
Anthem office in the US, you must be available to go to office for training,
technical computer issues, or if needed by needs of business.
+ Current,unrestricted RN license in applicable state(s) required.
+ 3 years of clinical experience (acute care desired ER, ICU,Med/Surg)
+ Multi-state licensure is required if this individual is providingservices in multiple states.
+ Experience with electronic documentation.
+ Knowledge and work experience with MS Office (Excel and Outlook).
+ Must be able to multi-task (talking and typing simultaneously).
+ Experience using pc s with multiple screens.
+ Bilingual a plus.
+ Ability to type 50 wpm with minimal errors.
+ Certification as a Case Manager is preferred.
+ Experience with Manage Care and Medicare a plus.
+ Telephonic Case Management a plus.
An 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
An Equal
Opportunity Employer/Disability/Veteran.