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Nurse Case Manager I/II (Job Family) - Iselin, NJ - PS21486 at Anthem, Inc.

Posted in Management 30+ days ago.

This job brought to you by eQuest

Type: Full-Time
Location: Iselin, New Jersey





Job Description:

Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide.

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, 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.

 

This is an exceptional opportunity to do innovative work that means more to you and those we serve. 

 

Nurse Case Manager I/II (Job Family) - Iselin, NJ


 

Please Note: This position may be filled at either the Nurse Case Manager I, or Nurse Case Manager II level.  Manager will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position.


 

This is a telephonic case manager position in the NJ Health Plan with the primary responsibility of performing initial assessments on members and reviewing assessment for care management.  No field work involved.

The Nurse Case Manager is responsible for care management within the scope of licensure for members with complex and/or chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.


 

Primary duties may include, but are not limited to:


  • Ensures member access to services appropriate to their health needs.

  • Conducts screenings or assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.

  • Implements care plan according to member's needs.

  • Coordinates internal and external resources to meet identified needs.

  • Monitors and evaluates effectiveness of the care management plan and modifies as necessary.

  • Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans as needed.

Qualifications:


  • Requires a BA/BS in a health related field; Diploma in Nursing required; BSN preferred; 3-5 years of acute care clinical experience, home health/discharge planning experience; or any combination of education and experience, which would provide an equivalent background.

  • Current, unrestricted RN license in the state of New Jersey required.

  • Intermediate or above skills in Microsoft Office programs (Excel, Outlook and Word).

  • Excellent verbal and written communications skills.

  • Certification as a Case Manager is preferred.

  • Prior managed care experience preferred. 

 

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc 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.