Anthem RN Field Nurse - LTSS Svc Coord-RN Clinician (Remote) Patrick County or Henry County, Virginia - PS14072 in St. Louis, Missouri
RN Field Nurse - LTSS Svc Coord-RN Clinician (Remote) Patrick County or Henry County, Virginia - PS14072
Location: United States
Requisition #: PS14072
Post Date: Nov 13, 2018
This is a field position supporting our LTSS (Long Term Services and Support) members in the Patrick County and Henry County, VA. 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.
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.
As the LTSS Svc Coord RN Clinician you will be responsible for overall management of members case within the scope of licensure; you may provide direction to non-RN clinicians participating in the members case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the members care plan to meet the members needs, with the goal of optimizing member health care across the care continuum.
You are responsible for performing face-to-face clinical assessments for the identification, evaluation, coordination and management of members' needs, including physical health, behavioral health, social services and long term services and supports. You would identify members for high risk complications and coordinates care in conjunction with the member and the health care team
You manage members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits
You would obtain thorough and accurate member history to develop individual care plans
As the Nurse Clinician you collaborate with the members, caregivers, family, natural supports, physicians to establish short and long term goals; identifies members that would benefit from an alternative level of care or other waiver programs
You, the RN Clinician will have overall responsibility to develop the care plan for services for the member and ensures the members access to those services.
You might 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
As the RN Clinician, you interface with Medical Directors, Physician Advisors and/or Inter-Disciplinary teams on the development of care management treatment plans
You may also have the opportunity to assist in problem solving with providers, claims or service issues
Additionally as the Nurse Clinician you may direct the work of other licensed professionals other than a Nurse, 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 members care plan to meet the members needs
You must have experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator role, Case Management role, or working with Medicaid, managed care and/or LTSS.
You must live in Patrick County or Henry County Virginia and have a current, unrestricted RN license in the state of Virginia
You must be able to travel locally; this position requires a reliable vehicle, current auto insurance and clean driving record (mileage, tolls reimbursed).
You must be competent in MS Office suite to include Word, Outlook and Excel, as well as be comfortable with computers in general (i.e. Apple products) since you will be entering assessments into an iPad and syncing the information with a laptop.
Preferred qualifications include:
Knowledgeable of involuntary psychiatric admissions related to emergency custody orders and temporary detention orders
Demonstrated ability to communicate with members who have complex medical needs and who may have communication barriers
Clinical nursing experience with medically complex members dependent on life sustaining equipment
Current or prior field/home health 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 antheminc.com/careers.
An Equal Opportunity Employer/Disability/Veteran