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Nurse Case Mgr I, for Developmentally Disabled Population, PS29116Location: Iselin, New Jersey, United StatesNewRequisition #: PS29116Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.This is an office-based position located at the NJ Health Plan, in Iselin, NJ.This is a telephonic case manager position with the primary responsibility of performing initial assessments on members. No field work involved.This Case Manager will assist families and their members with developmental disabilities to obtain services and support based upon their medical and psychosocial needs. Responsible for performing care management within the scope of licensure for members with 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 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.
RN Case Manager IRequires a BA/BS in a health related field; minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.Requirements:
Requires a minimum of one year experience working with people with special needs.
Current, unrestricted RN license in the state of NJ required.
Certification as a Case Manager is preferred.
Computer skills: MS Office - Word, Outlook, Excel
Prefer experience performing assessments on members in a health insurance company.
Must have excellent oral and written communication skills.
Must be organized, self-motivated, and detail oriented.
Must be able to sit and speak with people on the phone for extended periods of time.
Telephonic case management experience preferred.
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.
Vacancy caducado!