Anthem, Inc. Nurse Case Manager - RN in New York City, New York
SHIFT: Day Job
CareMore and Aspire Health are entering a new growth phase, as a proven care delivery model for the highest-risk. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. We build and lead integrated, multi-disciplinary clinical teams to care for the most complex patients and currently serve nearly 200,000 patients in 30+ states across Medicare, Medicaid, and commercial populations. We strive for excellence and have achieved significant and measurable improvement in total cost of care, clinical outcomes, and experience. As an Anthem subsidiary, we benefit from the scale and resources one of America’s largest managed healthcare organizations. As an Anthem subsidiary, we benefit from the scale and resources one of America’s largest managed healthcare organizations.
Responsible for managing quality, cost effective care using selective benefits and alternative services best suited for the member.
Primary duties may include, but are not limited to:
Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs.
Supports member or their representative in regard to care, care transitions, and changes in health status.
Implements a comprehensive clinical case management plan for each patient.
Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed.
Analyzes patient variances from the plan and initiates the appropriate steps to resolve variances.
Performs admission and concurrent stay reviews on hospitalized patients.
Develops and implements discharge planning for patients in conjunction with hospital based case managers.
Performs telephonic, fax and/or on-site reviews with skilled nursing facilities, home health agencies or other contracted service agencies to determine need for continued care.
LVN, LPN or RN; 2 years of experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted LVN, LPN, or RN license in applicable state(s) required.
For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc 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