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Wed Jun 6, 2018 - 23 weeks ago

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Field RN Case Manager I (Bilingual Spanish Preferred) – Dallas

Field RN Case Manager I (Bilingual Spanish Preferred) - Dallas, TX - PS7409


**Location:** **United States**

**Field:** Medical

**Requisition #:** PS7409

**Post Date:** 3 hours 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 care for our members, greater value for our customers and greater
health for our communities. Join us and together we will **drive thefuture of health care** .

This is an exceptional
opportunity to do innovative work that means more to you and those we

**Field RN Nurse Case Mgr.I - Remote in Texas (Dallas, Houston) but with about 20% field work.**

The Nurse Case Manager
is 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 toservices appropriate to their health needs.

+ Conducts assessments toidentify individual needs and a specific care management plan to addressobjectives and goals as identified during assessment.

+ Implements care plan by facilitatingauthorizations/referrals as appropriate within benefits structure orthrough extra-contractual arrangements.

+ Coordinates internal andexternal resources to meet identified needs.

+ Monitors and evaluateseffectiveness of the care management plan and modifies as necessary.

+ Interfaces with MedicalDirectors and Physician Advisors on the development of care managementtreatment plans.

+ Assists in problem solving withproviders, claims or service issues.

+ Requires a BA/BS in a healthrelated field; 3 years of clinical experience; or any combination ofeducation and experience, which would provide an equivalent background.

+ Current, unrestricted RNlicense in Texas required.

+ Case management experiencepreferred.

+ One opening preferred someonewho has Pediatrics experience with the other opening preferred someone whohas adults experience.

+ Experience with MCO preferred.

+ Bilingual in Spanish is aplus.

**_Anthem, Inc. is rankedas one of America's Most Admired Companies among health insurers by Fortunemagazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. Tolearn more about our company and apply, please visit us at_** **_. EOE. M/F/Disability/Veteran._**