Anthem In. Case Management Jobs

Job Information

Anthem, Inc. Manager I GBD Special Programs in Iselin, New Jersey

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

Location: This position will work from our Iselin, NJ office location.

The Manager I GBD Special Programs is responsible for managing a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources.

Primary duties may include, but are not limited to:

  • Assess the medical necessity of inpatient admissions, outpatient services, out of network services, and appropriateness of treatment setting and level of care.

  • Oversees process improvement, quality assurance, and adherence to applicable medical policy, care management best practices, relevant clinical standards, and member contract.

  • Ensures prevention and health management program accreditation standards are achieved.

  • Participates in establishing strategic plans and objectives; aligning, developing, and implementing functional area policies and procedures to support strategic plans and objectives.

  • Participates in establishing and managing the annual budget productivity targets.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

  • Requires a BS in Nursing.

  • 5 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.

  • Current, unrestricted RN license in the state of New Jersey required.

  • Certification as a Case Manager preferred.

  • Master's degree and/or certifications 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.

REQNUMBER: PS39913

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