Anthem Care Manager RN/LVN in Denver, Colorado

Care Manager RN/LVN

New

Location: Denver, Colorado, United States

Field: Medical

Requisition #: PS11741

Post Date: 5 days ago

CareMore Care Manager

What Is CareMore?

CareMore is 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 servenearly 200,000patients inmultiplestates 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.

CareMore’sHealth Networks, Primary Care+, Touch and CareMore@Home models drivestrategy, operations, and care delivery in our national markets (Arizona, California, Colorado, Connecticut, Iowa, Nevada, New York, Tennessee, Texas, Virginia and the District of Columbia), where CareMore builds and runs capitated primary care medical groups, at-risk health networks and upstream care delivery products in service of high-risk Medicaid, Medicare and commercial patients, andour collaboration with Emory Health System in Georgia. Our comprehensive,upstreamapproach tohealth is led by robust multidisciplinary teams ofextensivists (managing acute and post-acute episodes of care), primary care clinicians, behavioral health clinicians, care management & engagement specialists (including social workers, case managers and community health workers), and mobile home-based care teams. We continue to evolve our model to effectively engage and care for complex patients,led by ateam of passionate, execution-minded leaders dedicated to this mission.

Responsible for managing quality, cost effective care using selective benefits and alternative services best suited for the member.

Primary duties may include, but are not limited to:

  • Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs.

  • Supports member or their representative in regard to care, care transitions, and changes in health status.

  • Implements a comprehensive clinical case management plan for each patient.

  • Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed.

  • Analyzes patient variances from the plan and initiates the appropriate steps to resolve variances.

  • Performs admission and concurrent stay reviews on hospitalized patients.

  • Develops and implements discharge planning for patients in conjunction with hospital based case managers.

  • Performs telephonic, fax and/or on-site reviews with skilled nursing facilities, home health agencies or other contracted service agencies to determine need for continued care.

Qualifications:

  • Requires a LVN, LPN or RN; 2 years of experience; or any combination of education and experience, which would provide an equivalent background.

  • Current unrestricted LVN, LPN, or RN license in applicable state(s) required.

  • For CareMore business units, satisfactory completion of a pre-placement Tuberculosis test is a requirement for this position.

Anthem, Inc. is ranked as one of America’s MostAdmired Companies among health insurers by Fortune magazine and is a 2018DiversityInc magazine Top 50 Company for Diversity. To learn more about ourcompany and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.