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RN Case Manager I - Dallas For...

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Job Summary

Company
Anthem
Location
Grapevine, TX
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_139001

RN Case Manager I - Dallas Fort Worth, Texas (Bilingual Spanish Preferred) - 139001

About the Job

Description

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 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.
RN Nurse Case Manager I - Dallas Fort Worth, Texas (80% remote and 20% in the field)
The Nurse Case Manager 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 and on-site at hospitals, clinics or member's home.
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.
  • Assists in problem solving with providers, claims or service issues.

Qualifications
  • 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 Texas required.
  • Requires 80% remote work and 20% in the field
  • Certification as a Case Manager is preferred.
  • At least 3 years Med-Surg clinical experience strongly preferred.
  • Experience with chronic illnesses preferred.
  • Experience with Behavioral Health preferred.
  • Bilingual in Spanish is a plus.
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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