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.
Responsible for performing face to face and telephonic case management within the scope of licensure for members with behavioral health and physical health substance abuse or substance abuse disorder needs. Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED), Maternity, Alcohol / Drug, Autism Spectrum Disorders (ASD), etc.
Primary duties may include, but are not limited to:
Face to face visits with the member that include home visits, hospital and other community settings such as doctor's office, treatment centers, etc.
Responds to more complex cases and account specific requests.
Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs.
Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment.
Monitors and evaluates effectiveness of care plan and modifies plan as needed.
Supports member access to appropriate quality and cost effective care.
Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers.
Serves as a resource to other Behavioral health and physical health Case Managers.
Participates in cross-functional teams, projects and initiatives.
Responsible for performing telephonic and face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services.
Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
Support 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.
Will assist in problem solving with providers and the health care team.
This initiative includes 6 positions that can be filled between the Nurse Case Manager II position and the BH Case Manager II position.
We have openings in the following areas:
IA Waterloo, Independence, Vinton Cedar Rapids and Iowa City
CO Denver metro
KY Lexington metro
KY - Louisville metro
LA - Orleans Parrish (NOLA)
LA - Lafayette Parrish but some travel to Lake Charles and Baton Rouge, as needed.
MS or MA in social work, counseling, or a related behavioral health field or a degree in nursing and 3- 4 years of clinical experience in social work, counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment
Or any combination of education and experience, which would provide an equivalent background.
Current active unrestricted license as an RN, LCSW, LMHC, LPC, LMSW, LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure is required.
Previous experience in case management and face to face and telephonic coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders.
Managed care experience preferred.
Experience in health coaching and motivational interviewing techniques preferred.
Home visit experience is strongly preferred
Problem solving mentality
Great written and verbal communication
Proficient in Microsoft Office
Proficient typing skills
Must live within one of the following areas
LA - Orleans Parrish (NOLA)
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.