Anthem In. Case Management Jobs

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Anthem, Inc. Director I Healthcare Management - Arkansas (RN Preferred) in Little Rock, Arkansas

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 care companies and a Fortune Top 50 Company.

We are hiring a Director I Healthcare Management - Arkansas Medicaid. Responsible for managing the utilization or care management process for one or more member product populations of varying medical complexity ensuring the delivery of essential services that address the total healthcare needs of members.

Primary duties may include, but are not limited to:

• Implements and manages health care management, utilization, cost, and quality objectives.

• Ensures program compliance and identifies opportunities to improve the customer service and quality outcomes.

• Oversees the development and execution of medical and case management policies, procedures, and guidelines; assists in developing clinical management guidelines.

• Ensures medical management activities are contracted, reviewed and reported.

• Supports quality initiatives and activities including clinical indicators reporting, focus studies, and HEDIS reporting.

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

Qualifications

Requires a BA/BS degree in a health care field and a minimum of 8 years clinical experience including prior management experience; or any combination of education and experience which would provide an equivalent background.

RN, LCSW, or LPC preferred.

National Committee for Quality Assurance (NCQA) accreditation and HEDIS reporting experience preferred.

Certified Case Manager preferred.

This position is currently remote due to COVID. Once we have resumed all standard operations, this position will require office presence in our Little Rock, AR locations.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS55905

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