Posted in Management 24 days ago.
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Location: Raleigh, North Carolina
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 Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. company, it’s a powerful combination, and 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.
LTSS Svc Coord-Clinician - LPN/LVN, LSW, LCSW, or LMSW (Clinical License Other than RN) North Carolina Multiple Regions PS26201
Work Locations: This position requires you to work in the field visiting members up to 75% of the time. When not in the field, you will work from your home office.
We will be hiring in multiple Regions; Ashville, Charlotte, Elizabeth City, Fayetteville, Greenville, Raleigh/Durham, Wilmington, Winston-Salem.
Working under the direction/supervision of an RN, with overall responsibility for the member's case, as required by applicable state law and contract, contributes to the LTSS care coordination process by performing activities within the scope of licensure including, for example, assisting the responsible RN with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
• Assists responsible RN in identifying members for high risk complications.
• Obtains clinical data as directed by the responsible RN.
• Assists the responsible RN in identifying members that would benefit from an alternative level of care or other waiver programs.
• Provides all information collected to the responsible RN, who verifies and interprets the information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the member's care plan to meet the member's needs.
• Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by responsible RN, and in conjunction with the RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits.
• Decision making skills will be based upon the current needs of the member and require an understanding of disease processes and terminology and the application of clinical guidelines but do not require nursing judgment.
• Requires an LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law; Nursing Diploma or AS in Nursing or a related field; 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background. 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.
• Current, unrestricted LPN/LVN, LSW, LCSW, LMSW or license other than RN (as allowed by state law) in the state of North Carolina is required.
• Experience working with individuals who benefit from supports related to chronic illnesses, co-morbidities, behavioral health, and developmental delays in a Service Coordinator, Case Management, Advocate or similar role strongly preferred.
• Experience using a person centered approach to develop supports
• Strong computer skills to include Excel and Outlook as well as the ability to learn new applications and programs.
• Medicaid knowledge/experience preferred
• Experience in Long Term care preferred
• Up to 75% travel required within assigned territory.
• This position requires home visits as well as telephonic and virtual meetings.
• Waiver 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.