Anthem, Inc. Special Programs Case Manager II in Midland, Georgia
SHIFT: Day Job
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.
The Special Programs Case Manager is responsible for performing case management telephonically and/or by home visits within the scope of licensure for special programs, such as Foster Care. Manages overall healthcare costs for the designated population via integrated (physical health/behavioral health) case management and whole person health. Manages a significantly larger and more complex caseload as compared to Special Programs Case Mgr I. Serves as subject matter expert for the department.
Schedule: Remote, Monday – Friday, 8a-5p
Primary duties may include, but are not limited to:
Conducts assessments to identify individual needs.
Develops comprehensive care plan to address objectives and goals as identified during assessment.
Supports member access to appropriate quality and cost effective care and modifies plan(s) as needed.
Coordinates with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole person care.
Coordinates social determinants of health to meet the needs of the member and incorporates that into care planning.
Works closely with various state agencies.
Maintains knowledge of the system of care philosophy; a spectrum of effective, community-based services and supports for those with or at risk for mental health or other challenges and their families, that is organized into a coordinated network.
Builds meaningful partnerships with designated populations and their families, and addresses cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
Evaluates health needs and identifies applicable services and resources in conjunction with members and their families.
Provides important information including patient education, medication reconciliation, and identification of community resources and assists with arrangement of follow-up care.
Works on strategic projects related to specialty populations. Assists with onboarding new associates.
Requires MS/MA in social work, counseling, or a related behavioral health field or a degree in nursing and minimum of 5 years of clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
Current active unrestricted license as an RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
Basic IGCM and Advanced IGCM internal integrated case management certification required.
Certified Case Manager Certification is also required.
Clinical experience in social work counseling with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred.
Experience working with specialty populations preferred.
For Government business only, LAPC, LAMFT, LMSW (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply. Travel may be required.
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.