MiamiRecruiter Since 2001
the smart solution for Miami jobs

Nurse Case Manager I - FL Medicaid Case Management

Company: Anthem, Inc.
Location: Miami
Posted on: February 25, 2021

Job Description:

Welcome to the Anthem Careers site! We have been hard at work to improve our job search and application systems to better serve you. It is now easier to find and apply for relevant jobs as well as stay connected with Anthem. Here are a few of the updates you may notice:

  • No more profiles! We no longer require you to create a log in and password to apply for a job and you won't be able to access previously created profiles, but don't worry - we still have your previous application(s) on file and you can still track your status by clicking on the "Track Your Job Application Status" button.
  • Job Alerts - If you had previously registered to receive job alerts and wish to continue to receive these notifications, please re-register by clicking the "job alert" button.
  • NEW! Didn't find a job that is right for you? Join a Talent Network to stay informed on news and job opportunities with the Anthem Team! It is important that you apply using an email address which is unique to you and not shared with a friend, relative, spouse, or significant other. Our recruiting system uses your email address as your unique identifier. If you apply with a shared email address, your application will overwrite any previous applicant record with the same email address. Additionally, please ensure that you use a valid email address, free from typos, as there are a variety of communications which may be sent to the email address 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 benefits companies and a Fortune Top 50 Company. Location: Miami, FL; Ft. Lauderdale, FL; or W. Palm Beach, FL -- Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. Primary duties may include, but are not limited to:
    • -- Ensures member access to services appropriate to their health needs.
    • Conducts assessments to identify individual needs and a specific care management plan to address objectives and
    • goals as identified during assessment. Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
    • Coordinates internal and external resources to meet identified needs.
    • Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
    • Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
    • Negotiates rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service
    • issues.
    • Traveling and conducting home visits Requirements:
      • Requires a BA/BS in a health related field; 3 years of clinical experience; or any combination of education and
      • experience, which would provide an equivalent background.
      • Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is
      • providing services in multiple states.
      • Certification as a Case Manager is preferred.
      • Must have OB experience. For URAC accredited areas the following applies:
        • Requires a BA/BS; 3 years of clinical care experience; or any combination of education and experience, which
        • would provide an equivalent background.
        • Current and active RN license required in applicable state(s).
        • 5 years of experience, certification as a Case Manager from the approved list of certifications, and a BS in a health
        • or human services related field preferred. Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc. 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 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 ability@icareerhelp.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., Miami , Nurse Case Manager I - FL Medicaid Case Management, Executive , Miami, Florida

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Remote Biotech Clinical Trials Project Leadership Director
Description: A healthcare company is filling a position for a Remote Biotech Clinical Trials Project Leadership
Company: VirtualVocations
Location: Miami
Posted on: 03/1/2021

Staff Accountant- AP Management
Description: A well-established hospitality company, Silverspot offers a competitive salary and great benefits For corporate and management positions, Silverspot covers 100 of employee only health insurance, dental, (more...)
Company: Silverspot Cinemas
Location: Miami
Posted on: 03/1/2021

Medical Director
Description: Location: The central city of Palm Beach County and located along Florida's Atlantic Ocean Coast, West Palm Beach offers year-round excitement within easy reach of smooth-sand beaches and some of the (more...)
Company: BAS Healthcare, Inc
Location: West Palm Beach
Posted on: 03/1/2021


Director of Real Estate (South Florida) - Miami
Description: Company Description br br About KIPP Miami br br KIPP Miami is part of the KIPP Knowledge is Power Program national nonprofit network of college-preparatory, public charter schools educating (more...)
Company: KIPP Miami
Location: Miami
Posted on: 03/1/2021

Senior Vice President - Brand Practice, Leading Multicultural Agency - Miami, FL
Description: A leading multicultural communications agency is looking for a dynamic Senior Vice President to join their growing team. If you're looking for an environment rooted in diversity and working with leading (more...)
Company: Monday Talent
Location: Miami
Posted on: 03/1/2021

SENIOR PROJECT MANAGER - MIAMI, FL
Description: SENIOR PROJECT MANAGER - MIAMI, FLDelta Construction Partners is a national executive search firm for the nation's premier general contractors and industry professionals. Delta has been retained to conduct (more...)
Company: Delta Construction Partners, Inc.
Location: Miami
Posted on: 03/1/2021

Children/Adolescent Case Manager (Broward)
Description: Assess the child's living environment, determine the individual's strengths, weaknesses and needs, as well as determine the strengths and needs of the recipient's natural support system. Assess the (more...)
Company: Citrus Health Network, Inc.
Location: Miami
Posted on: 03/1/2021

Sales Director
Description: OUTFRONT Media has an opportunity for an experienced sales leader to motivate a team of account executives with a focus on media integration, client engagement and smart strategies. As the largest Out (more...)
Company: Outfront Media
Location: Miami
Posted on: 03/1/2021

General Manager
Description: EquipmentShare is Hiring a General Manager. br br EquipmentShare is searching for an experienced General Manager to launch and grow our rental location in Miami, FL. br br About EquipmentShare (more...)
Company: EquipmentShare
Location: Miami
Posted on: 03/1/2021

Sourcing Coordinator/Product Manager
Description: ul li date posted: Wednesday, February 24, 2021 li experience: Experienced li job type: Permanent li industry: manufacturer of curtains/draperies li reference: AB 3578678 li questions: (more...)
Company: Randstad USA
Location: Miami
Posted on: 03/1/2021

Log In or Create An Account

Get the latest Florida jobs by following @recnetFL on Twitter!

Miami RSS job feeds