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Care Coordinator at Anthem, Inc.

Posted in Management 30+ days ago.

This job brought to you by eQuest

Type: Full-Time
Location: Raleigh, North Carolina





Job Description:

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

What Is CareMore?

CareMore is entering a new growth phase, as 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 and currently serve nearly 200,000 patients in multiple states across Medicare, Medicaid, and commercial populations.  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.

 

CareMore’s Health Networks, Primary Care+, Touch and CareMore@Home models drive strategy, operations, and care delivery in our national markets (Arizona, California, Colorado, Connecticut, Iowa, Nevada, New York, North Carolina, Tennessee, Texas, Virginia and the District of Columbia), where CareMore builds and runs capitated primary care medical groups, at-risk health networks and upstream care delivery products in service of high-risk Medicaid, Medicare and commercial patients, and our collaboration with Emory Health System in Georgia. Our comprehensive, upstream approach to health is led by robust multidisciplinary teams of extensivists (managing acute and post-acute episodes of care), primary care clinicians, behavioral health clinicians, care management & engagement specialists (including social workers, case managers and community health workers), and mobile home-based care teams. We continue to evolve our model to effectively engage and care for complex patients, led by a team of passionate, execution-minded leaders dedicated to this mission.

 

For more information, visit http://www.caremore.com/

Responsible for coordinating the delivery of care for members. 

Primary duties may include, but are not limited to: 


  • Implements, coordinates, monitors, and evaluates options and services to meet member's health needs and ensures appropriate use of clinical resources. 

  • Monitors delivery of care across all markets. Maintains daily admissions and discharge records. 

  • Expedites and coordinates appointments for assigned hospitalized patients. Authorizes and coordinates services. 

  • Keeps all providers involved with member's care updated on appointments, condition, and additional clinical support needed.

  • Requests and gathers necessary medical records. 

  • Maintains accurate and complete documentation in Case Management database. 

Requires a high school diploma; 2 years of experience in Case Management Care Coordination in an HMO environment; or any combination of education and experience, which would provide an equivalent background. Medical Assistant Certification 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.