Manager l (RN) InPatient Medicaid
Company: Anthem, Inc.
Location: Saint Louis
Posted on: February 23, 2021
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with which you apply 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 care
companies and a Fortune Top 50 Company. Location: This position is
currently allowing work from home but in the future, you must be
able and willing to work from an Anthem office. You must currently
reside within daily commuting distance to an Anthem office. The
Manager l Health Care Management is responsible for managing a team
of physical health practitioners responsible for coordinating
member service, utilization, access, concurrent review to ensure
cost effective utilization of health, for one or more member
product populations of varying medical complexity ensuring the
delivery of essential services that address the total healthcare
needs of members. Primary duties may include, but are not limited
- Manages and oversees team responsible in case finding and
coordinating cases that involve comorbid conditions.
- Coordinates service delivery to include member assessment of
physical and psychological factors.
- Partners with providers to establish short and long term goals
that meet the member's needs, functional abilities, and referral
- Identifies members with potential for high risk
- Reviews benefit systems and cost benefit analysis.
- Evaluates medical, mental health and substance abuse service
for cost containment.
- Supports program compliance and assists in identifying
opportunities to improve the customer service and quality
- Supports quality initiatives and activities, including
adherence to National Committee for Quality Assurance (NCQA)
standards and HEDIS reporting.
- Hires, trains, coaches, counsels, and evaluates performance of
- Strategic planning and cost of care development, generation of
- Requires a BA/BS; 5 years of experience in Health Care
Management; or any combination of education and experience, which
would provide an equivalent background.
- Current active unrestricted RN, license (as allowed by
applicable state laws); and any other state or federal requirements
that may apply is required.
- Prior Utilization Management preferred, managed care experience
- Experience managing a team either directly or indirectly
preferred. We offer a range of market-competitive total rewards
that include merit increases, paid holidays, Paid Time Off, and
incentive bonus programs (unless covered by a collective bargaining
agreement), medical, dental, vision, short and long term disability
benefits, 401(k) + match, stock purchase plan, life insurance,
wellness programs and financial education resources, to name a few.
Anthem, Inc. is ranked as one of America's Most Admired Companies
among health insurers by Fortune magazine and has been named a 2019
Best Employers for Diversity by Forbes. To learn more about our
company and apply, please visit us at careers.antheminc.com. An
Equal Opportunity Employer/Disability/Veteran. Anthem promotes the
delivery of services in a culturally competent manner and considers
cultural competency when evaluating applicants for all Anthem
positions. Please be advised that Anthem only accepts resumes from
agencies that have a signed agreement with Anthem. Accordingly,
Anthem is not obligated to pay referral fees to any agency that is
not a party to an agreement with Anthem. Thus, any unsolicited
resumes, including those submitted to hiring managers, are deemed
to be the property of Anthem. EEO is the Law Please use the links
below to review statements of protection from discrimination under
Federal law for job applicants and employees. Anthem, Inc. is
committed to helping individuals with disabilities participate in
the workforce and ensuring equal opportunity to apply and compete
for jobs. If you are an individual with a disability and require a
reasonable accommodation to complete the application process,
please email Human Resources at email@example.com for further
assistance. *WARNING : Please beware of phishing scams that solicit
interviews or promote work-at-home opportunities, some of which may
pose as legitimate companies. Please be advised that Anthem will
never ask you for a credit card, send you a check, or ask you for
any type of payment as part of consideration for employment with
our company. If you feel that you have been the victim of a scam
such as this, please report the incident to the Federal Trade
Commission here by selecting the 'Rip-offs and Imposter Scams'
option. Anthem requires a completed online application for
consideration of employment for any position.
Keywords: Anthem, Inc., St. Louis , Manager l (RN) InPatient Medicaid, Healthcare , Saint Louis, Missouri
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