RN Ltss Field Service Coordinator - Shelby County - TN Medicaid (Ps17914)

Anthem, Inc. Cordova , TN 38016

Posted 6 days ago

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it's a powerful combination. It's 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.

Location: This position will require you to work in the field approximately 75% of the time. When not in the field, you will work from your home office. This role will cover the Shelby County area and possibly some of the surrounding counties.

The LTSS Service Coordinator-RN Clinician for the Tennessee Health Plan is responsible for overall management of the member's case within the scope of licensure; may provide supervision or direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's person-centered support plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.

  • The RN has overall responsibility to develop the person-centered support plan for services for the member and ensures the member's access to those services.

  • Assists with the implementation of member care plans by facilitating authorizations / referrals for utilization of services, as appropriate, within benefits structure.

  • Performs 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 and long term services and supports.

  • Visits members in their homes, nursing facilities, physician's offices, hospitals, and other provider facilities.

  • Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.

  • Manages 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 a person-centered support 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.

  • Interfaces with members of the health care team on the development of person-centered support and care management treatment plans.

  • May also assist in problem solving with providers, claims or service issues.

  • May direct and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, 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 member's care plan to meet the member's needs.


  • Current, unrestricted RN license in the state of Tennessee; 2 or more years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.

  • Previous Case Management experience in Medicaid and / or Medicare preferred

  • Proficiency in using computers and computer software packages required.

  • Must be able to travel throughout assigned territory 75% of the time. (Mileage will be reimbursed according to current IRS guidelines.)

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.

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Senior Software Developer / Shelby Systems

Fellowship Technologies

Posted 2 days ago

VIEW JOBS 3/18/2019 12:00:00 AM 2019-06-16T00:00 Senior Software Developer Shelby Systems / Cordova TN Summary/Objective Senior Software Developer position is responsible for writing application code to contribute to the full lifecycle of development from concept to post-production support and maintenance of server / OS / desktop / web / mobile applications and services. This position will develop application code, contribute to version-controlled source code repositories and will managed assigned tasks to create measurable value and deliver software to market using industry recognized agile methodologies and best practices. The Staff Developer II will be responsible for coding according to prescribed standards and guidelines set forth by the architects and leadership teams and must demonstrate quality, brevity and timeliness in all deliverables. Essential Functions * Develop application code according to requirements and assigned tasks. * Contribute to lifecycle Flow and value streams by following prescribed methodologies and best practices. * Maintain balance of business and technical acumen in decision making. * Follow source-code management and work item tracking best practices. * Contribute to the estimation process during planning exercises. Competencies * Must demonstrate good decision making and effective business acumen. * Must be able to communicate in both written and verbal form. * Must maintain confidentiality of work related information and materials. * Must have a growth mindset and subscribe to a continuous learning philosophy. * Demonstrate expertise and mastery in your area of technology and industry. * Must establish and maintain effective working relationships. Required Education and Experience * 4+ years professional experience performing software development tasks including coding and QA. * Comprehensive knowledge with respect to the following: * C#, .NET (Standard and Core) * JavaScript (JQuery and AngularJS), HTML5, CSS3, Bootstrap * Relational Databases (SQL Server preferred) * Web Services (SOAP, XML, JSON, REST) * ASP.NET MVC and Web API * Working knowledge of toolsets such as: * Build Tools: VSTS Online/TFS, TeamCity, Jenkins, Bamboo * Source Control: Git or like * Work Request Systems: TFS, Jira * SDLC Methodologies: * Agile, SCRUM, use of architectural patterns/frameworks * Ability to collaborate on requirements for projects and request * Ability to properly assess and articulate risk Preferred Education and Experience B.S. or higher in computer science/technology field preferred or equivalent industry experience. * Excellent customer-service orientation * Effective delegation of tasks and follow-up * Lead technology assessments and author recommendations * Knowledgeable of system and software quality assurance best practices and methodologies * Capable of meeting deadlines and focuses on results and value creation * Capable of professionally resolving team issues/conflicts * Works well with customers and vendors, knows when and how hard to push to maintain a stable and reliable environment * Capable of leading research into application development issues to successful completion * Self-motivated and directed * Capable of prioritizing and execution of tasks in a high-pressure environment * Knowledge of applicable data privacy practices and regulations preferred (PCI, PII, PHI, HIPAA, GDPR, ADA, etc.) ABOUT MINISTRY BRANDS We are the leading Software-as-a-Service ("SaaS") platform for Faith-Based Organizations ("FBOs"). We are the only comprehensive End-To-End technology solution for FBOs who are at the early stage of technology adoption propelling rapid growth. We are a single team, supporting a family of partners who share a common vision: empower the church to produce better results through technology. Ministry Brands is proud to be an Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Fellowship Technologies Cordova TN

RN Ltss Field Service Coordinator - Shelby County - TN Medicaid (Ps17914)

Anthem, Inc.