Location: Richmond, VA
Job Family: Medical
Req #: PS36222-Richmond-Richmond
Date Posted: Jul 9, 2020
DescriptionSHIFT: Day Job
HOURS: 8:00 am – 5:00 pm, Monday through Friday.
Responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract. This does not involve clinical judgement.
Primary duties include, but are not limited to:
Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with predefined questions for the identification, evaluation, coordination and management of member's program needs.
Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of services.
Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, and physicians. Identifies members that would benefit from expanded services.
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.