Anthem, Inc. CareMore Care Manager in Richmond, Virginia
SHIFT: Day Job
Your Talent. Our Vision. At CareMore, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination. It’s 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.
CareMore is 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. 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.
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 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.
Requires a RN and minimum of 2 years of nursing experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted RN license in the state of Virginia is required.
Satisfactory completion of a Tuberculosis test is a requirement for this position.
Prefer 5+ years of hospital Case Management experience.
Knowledge of utilization and discharge planning.
Experience with Managed Care and Medicade/Medicare preferred.
Experience working remotely is a plus.
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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. 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. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact email@example.com for assistance.