18 Sep
CareMore Manager II Case Management
California, Westcovina 00000 Westcovina USA

Vacancy expired!

Description SHIFT: Day JobSCHEDULE: Full-timeCareMore and Aspire Health are 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 30+ 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.Responsible for managing a team of nurse care managers engaged in assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs. Primary duties may include, but are not limited to:

Responsible for process improvement, quality assurance, and adherence to appropriate medical policy, care management best practices, relevant clinical standards, and member contract.

Serves as mentor to lower leveled managers and as subject matter expert for other areas of the company and within the department.

Manages multiple functions requiring unique sets of knowledge or has significant fiscal accountability.

Develops and manages annual operating budget.

Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

Requires a BA/BS in a health related field;

5 years of clinical experience;

2 years of prior management experience; or any combination of education and experience, which would provide an equivalent background.

Current, unrestricted RN or SW license in applicable state(s) required. Certification as a Case Manager is preferred.

For URAC accredited areas the following applies:

Requires a BA/BS;

5 years of clinical care experience;

2 years of prior management experience; or any combination of education and experience, which would provide an equivalent background.

Current and active RN or SW license required in applicable state(s).

Certification as a Case Manager from the approved list of certifications and a BS in a health or human services related field preferred.

Managers who have directly supervised the case management process for three or more years must hold a certification as a case manager and meet continuing education requirements to maintain licensure and certification.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc. 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.REQNUMBER: PS39157

Vacancy expired!


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