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Nurse Case Mgr I - 11:30am - 8...

Monster
 
 
 
 

Job Summary

Company
Anthem
Location
Louisville, KY
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_139720

Nurse Case Mgr I - 11:30am - 8pm, Weekdays (Shift pay eligible) - Louisville, KY (139720VMJ)

About the 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.

Work Hours: 11:30am - 8pm, Monday - Friday.. eligible for 10% shift pay for the late hours worked.

Location: This position will be based in our Louisville, KY office for the first year. After successful completion of 1 year in position, there may be an opportunity to work@home.

The Nurse Case Manager I 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 for discharge planning. 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 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 with Medical Directors and Physician Advisors on the development of care management treatment plans.
  • Negotiates rates of reimbursement, as applicable.
  • Assists in problem solving with providers, claims or service issues.


Qualifications

The Nurse Case Manager l requires:

  • BA/BS; 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background.
  • Current, active Kentucky RN license required.
  • Multi-state licensure is required.
  • Must be able to work 11:30am - 8pm, Monday - Friday.
  • Managed care/health insurance industry required.

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.

 

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