Anthem, Inc. CareMore Care Manager in Raleigh, North Carolina
SHIFT: Day Job
CareMore Care Manager Location: Raleigh, North Carolina RN Only (BSM Degree a Plus)
The CareMore Care Manager is 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 regarding 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. 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.
• Requires a RN license; 2 years of experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in applicable state(s) required. For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position. BSM Degree preferred.