LTSS Service Coordinator-RN Clinician

Local Jobs Anthem
  • United States, Suffolk, VA View on Map
  • Post Date: June 18, 2020
  • Apply Before : July 18, 2020
  • Share:

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., 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. Together we can drive the future of health care.

This is a field position supporting our LTSS (Long Term Services and Support) members in the Suffolk, VA area. When not in the field, you will be working from home (mileage reimbursed). You must have the flexibility to come into an Anthem office for meetings if needed. Related computer equipment for a home office will be provided. You must have a high speed data connection.
The LTSS Service Coordinator-RN Clinician is responsible for overall management of member’s case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member’s case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member’s care plan to meet the member’s needs, with the goal of optimizing member health care across the care continuum.
  • Responsible for performing telephonic or face-to-face clinical 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.
  • Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
  • Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.
  • Obtains a thorough and accurate member history to develop an individual care plan.
  • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs.
  • The RN has overall responsibility to develop the care plan for services for the member and ensures the member’s access to those services.
  • May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
  • May also assist in problem solving with providers, claims or service issues.
  • Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member’s care plan to meet the member’s needs, and reviewing and providing input on the non-RN clinicians’ performance on a regular basis.

Qualifications

  • Requires an RN; 3-4 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required. Masters in Health/Nursing preferred.
  • May require state-specified certification based on state law and/or contract.
  • Travel required.
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.

 

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LTSS Service Coordinator-RN Clinician

Local Jobs Anthem
  • United States, Norfolk, VA View on Map
  • Post Date: June 11, 2020
  • Apply Before : July 11, 2020
  • Share:

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc. 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.
This is a field position supporting our LTSS (Long Term Services and Support) members in the Chesapeake, Norfolk, Portsmouth, and Suffolk area. When not in the field, you will be working from home (mileage reimbursed). You must have the flexibility to come into an Anthem office for meetings if needed. Related computer equipment for a home office will be provided. You must have a high speed data connection.


The LTSS Service Coordinator-RN Clinician is responsible for overall management of member’s case within the scope of licensure; provides direction to non-RN clinicians participating in the member’s case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member’s care plan to meet the member’s needs, with the goal of optimizing member health care across the care continuum.
  • Responsible for performing telephonic or face-to-face clinical 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.
  • Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
  • Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.
  • Obtains a thorough and accurate member history to develop an individual care plan.
  • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs.
  • The RN has overall responsibility to develop the care plan for services for the member and ensures the member’s access to those services.
  • May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible.
  • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
  • May also assist in problem solving with providers, claims or service issues.
  • May direct the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member’s care plan to meet the member’s needs, and reviewing and providing input on the non-RN clinicians’ performance on a regular basis.


Qualifications

  • Requires an RN; a minimum of 3 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN license in Virginia is required.
  • Masters in Health/Nursing preferred.
  • Bi-lingual Spanish a plus.
  • Local travel required (mileage reimbursed).
  • Knowledge of long term care, Medicaid, managed care preferred.
  • Field experience (home health, etc.) preferred.
  • Computer skills: MS Office (Word, Outlook, Excel) Facets, Care Compass a plus. You must be comfortable working on a computer. You will be working on multiple screens, utilizing web-based applications and updating excel spreadsheets.
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 antheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran

 

“How to Find a Job” Books

We may earn a commission if you click on some of the links below and make a purchase at no additional cost to you.


How to Find a Job Books

Finding A Remote Job A Complete Guide – 2020 Edition

Finding A Remote Job A Complete Guide - 2020 Edition

Do you have the right kind of job? How should implementation be staged? Where are you prepared to go for a job? What are the main goals of your job club? Is building culture possible with a remote team?

Defining, designing, creating, and implementing a process to solve a challenge or meet an objective is the most valuable role… In EVERY group, company, organization and department.

VIEW BOOK


Breakthrough Remote Job: Earn rewards for answering questions on products you already used and love. Products such as Microsoft, Linkedin, WordPress, Postmates, Samsung Galaxy Phones, Air BnB etc.

Breakthrough Remote Job: Earn rewards for answering questions on products you already used and love. Products such as Microsoft, Linkedin, WordPress, Postmates, Samsung Galaxy Phones, Air BnB etc.

Earn rewards for answering questions on products you already used and love.

Products such as Microsoft, Linkedin, WordPress, Postmates, Samsung Galaxy Phones, Air BnB etc.

I earn weekly for helping WordPress customers with their problems. My job is to reply emails, chat customers and answer questions, most of which we already have answers to in our HUB and forum.

You can join too as it is available to anyone of any age worldwide.

VIEW BOOK


Remote: Office Not Required

Remote: Office Not Required

For too long our lives have been dominated by the ‘under one roof’ Industrial Revolution model of work. That era is now over. There is no longer a reason for the daily roll call, of the need to be seen with your butt on your seat in the office. The technology to work remotely and to avoid the daily grind of commuting and meetings has finally come of age, and bestselling authors Jason Fried and David Heinemeier Hansson are the masters of making it work at tech company 37signals. Remote working is the future – and it is rushing towards us.

VIEW BOOK


Why Working-From-Anywhere-Companies Attract the Best Talent: A Guide for Companies, Employees and Remote Job Seekers

Why Working-From-Anywhere-Companies Attract the Best Talent: A Guide for Companies, Employees and Remote Job Seekers

If your dream job is not related to a location, an office or a cubicle farm, then this book is for you. Look at a job in a totally new way and start enjoying life while being more productive.

Employers will like this book and embrace working-from-anywhere to have more engaged employees, attract top talent and save big on the bottom line.

VIEW BOOK


Read More

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