Anthem, Inc. Nurse Case Manager I (Bilingual preferred) in Modesto, California
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.
Nurse Case Manager I – Medicare - Model of Care (9:30am - 6:30pm) – PS57993
Work Location : Work from Home position. Must reside within 1-hour commute to an Anthem office and be willing to go to the office in the future for training and/or technical or computer issues.
Location : Work@Home.
Work Hours: 8-hour shift between 9:30am – 6:30pm (Time zone where candidate resides.)
The Nurse Case Manager I - Model of Care is responsible for completing CMS required DSNP activities for health risk assessment (HRA), interdisciplinary care team (ICT), and individualized care plan (ICP) and performs care management telephonically 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. 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 referrals as appropriate within benefits structure or through extracontractual 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 interdisciplinary team on the development of care management treatment plans.
Assists in problem solving with providers, claims or service issues.
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 the state of residence and ability to obtain multi-state licensure required.
Experience using electronic documentation.
Experience using MS Word, Excel and Outlook.
3 or more years of RN clinical experience in hospital/acute care, i.e. ER, ICU, Med/Surg, critical care, etc.
Experience within Managed Care industry and/or with Medicare a plus.
Telephonic Case Management a plus.
Certification as a Case Manager is preferred.
Bilingual a plus (Spanish, Vietnamese)
Applicable to Colorado Applicants Only
Annual Salary Range*: $58,720 - $74,300
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
- The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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.