Remote Nurse Care Manage I

Company: Anthem, Inc
Location: Fresno
Posted on: June 25, 2022

Job Description:

Description SHIFT: Day JobSCHEDULE: Full-time Job Title: Remote Nurse Care Manager I (Considering Registered Nurse (RN) candidates throughout the US, with the ability to work Est. hours). Please Note: Associates in this job are paid hourly and are eligible for overtime. Location: Remote/Work From Home (Considering Registered Nurse (RN) candidates throughout the United States, preferably those who can accommodate working Central or Eastern Region hours) *Selected candidate must ensure work at home office is in a dedicated private and secure room adhering to HIPPA compliance regulations. High-Speed home internet (Company Approved types) required with 20mb download and 5mb upload, directly connected/wired to Work Computer capabilities. May be required to go to the nearest Anthem/Pulse point offices if needed. Business Hours: Monday - Friday - 8am-7pm Est. Working Hours: Monday-Friday - 10am-7pm Est* * Some late nights and weekends may be required. This is not a flex role, would have to confirm shift hours with Hiring Manager. Training/Orientation Schedule: Monday-Friday - 8am-5pm Est. for the first 3 weeks of training plus mentoring time, will be 8-5pm Est. before moving to scheduled hours Be part of an extraordinary team! We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact? How you will make an impact: Responsible for collaborating with healthcare providers and/or consumers to drive personalized health management and improve health outcomes for optimal consumers. Performs care management activities within the scope of licensure for members with complex and chronic care needs. Primary duties may include, but are not limited to: + Responsible for collaborating with healthcare providers and/or consumers to drive personalized health management and improve health outcomes for optimal consumers. + Performs care management activities within the scope of licensure for members with complex and chronic care needs. + Ensures medically appropriate, high quality, cost-effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out-of-network services, and appropriateness of treatment setting and level of care. + Partners with physician clinical reviewers and/or medical directors to interpret the appropriateness of care, intervention planning, and general clinical guidance. + Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge. + Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan. + Monitors and evaluates the effectiveness of the care management plan and modifies it as necessary. Qualifications Minimum Requirements: + Requires minimum of 3 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state(s) required. + Multi-state licensure is required if this individual is providing services in multiple states. Preferred Skills, Capabilities and Experiences: + Home health/discharge planning experience preferred. + AS or BS in nursing preferred. Certification as a Case Manager is preferred. + Excellent proficiency with computer skills. + Strong communication skills (verbal and written). + Ability to work late nights and weekends as needed. 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 Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. 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 age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance. REQNUMBER: PS72399-California

Keywords: Anthem, Inc, Fresno , Remote Nurse Care Manage I, Healthcare , Fresno, California