Remote Nurse Care Manage I
Company: Anthem, Inc
Location: Fresno
Posted on: June 25, 2022
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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
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