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Nurse Disease Management (Care...


Job Summary

Atlanta, GA
Other/Not Classified
Job Type
Full Time
Career Level
Experienced (Non-Manager)
Job Reference Code

Nurse Disease Management (Care and Case Management) II - Atlanta, GA - PS4424

About the Job


Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it's a powerful combination. It's 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.

Location: Atlanta, GA; however, the ideal candidate will have the opportunity to work from home after successful completion of training and with proven satisfactory work performance.

Responsible for participating in and delivery of more complex patient education and disease management interventions and performs health coaching for members, across multiple lines, for health improvement/management programs for chronic diseases.

Primary duties may include, but are not limited to:

  • Conducts behavioral or clinical assessments to identify individual member knowledge, skills and behavioral needs.
  • Identifies and/or coordinates specific health coaching plan needs to address objectives and goals identified during assessments. Interfaces with provider and other health professionals to coordinate health coaching plan for the member.
  • Implements and/or coordinates coaching and/or care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs.
  • Uses motivational interviewing to facilitate health behavior change.
  • Monitors and evaluates effectiveness of interventions and/or health coaching plans and modifies.
  • Directs members to facilities, community agencies and appropriate provider/network.
  • Serves as a resource to lower-leveled DM associates.
  • Refers member to catastrophic case management as appropriate.
  • Requires an AS/BS in nursing; 5 years of condition specific clinical or home health/discharge planning experience; or any combination of education and experience, which would provide an equivalent background.
  • Current unrestricted RN license from the state of Georgia required
  • Prior case management experience preferred.
  • Experience working with diabetics, hypertensives, and asthmatics members required
  • AE-C (Certified Asthma Educator) or CDE (Certified Diabetic Educator) certifications preferred
  • CCM (Certified Case Manager) or CMCN (Certified Managed Care Nurse) preferred
  • Managed Care experience preferred
  • Health education or Public Health experience preferred

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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