Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.
Nurse Case Manager I/II for Developmentally Disabled- Iselin, NJ 122792
This is an office-based position located at the NJ Health Plan, in Iselin, NJ.
This is a telephonic case manager position with the primary responsibility of performing initial assessments on members. No field work involved.
This Case Manager will assist families and their members with developmental
disabilities to obtain services and support based upon their medical and psychosocial needs. Responsible for performing care management within the scope of licensure for members with chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically.
Primary duties may include, but are not limited to:
• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care
management plan to address objectives and goals as identified during
• Implements care plan by facilitating authorizations/referrals as appropriate
within benefits structure or through extra-contractual arrangements.
• 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.
• Assists in problem solving with providers, claims or service issues.
RN Case Manager I
Requires a BA/BS in a health related field; minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
RN Case Manager II
BA/BS in a related health field preferred; Requires 5 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background.
Requirements for both levels:
• Requires a minimum of one year experience working with people with special needs.
• Current, unrestricted RN license in the state of NJ required.
• Certification as a Case Manager is preferred.
• Computer skills: MS Office - Word, Outlook, Excel
• Prefer experience performing assessments on members in a health insurance company.
• Must have excellent oral and written communication skills.
• Must be organized, self-motivated, and detail oriented.
• Must be able to sit and speak with people on the phone for extended periods of time.
• Telephonic case management experience preferred.
Please Note: This position may be filled at either the RN Case Manager I or RN Case Manager II level. Manager will determine level based upon the selected applicant's skillset relative to the qualifications listed for this position.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2015 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.
Title: RN Nurse Case Manager I/II for Developmentally Disabled Population - Iselin, NJ 122792
Other Locations: NY-Staten Island, NJ-Iselin
Requisition ID: 122792
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