Skip to main content

Managed Care Coordinator - Virginia (Field/Remote) PS36222

Location: Richmond, VA
Job Family: Medical
Req #: PS36222-Richmond-Richmond
Date Posted: Jul 9, 2020

Description

SHIFT: Day Job

SCHEDULE: Full-time

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 healthcare.
 
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:  This is a non-exempt, field-based position that will service our members in Virginia, with up to 50% of local travel within an assigned territory.  The territories are: Fairfax County area, Fredericksburg area, Richmond, Tidewater area or SW Virginia (Tazewell County and vicinity) area. When you are not in the field, you will work remotely from home.  Occasional office visits for meetings and/or training are required. 
 

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.



Qualifications

  • Virginia residency is required.
  • Requires a BA/BS in a health-related field.
  • 1 year of related experience is required. 
  • The related experience should include working directly with people in a behavioral health environment, a peer support services role, or related community-based organizations.
  • Peer Support/Recovery experience - certification is required.
  • Experience working with community resource groups strongly preferred.
  • 35-50% local travel required (mileage and tolls reimbursed).  You must be comfortable visiting members in their homes or in a care facility.
  • Bilingual language skills preferred (English-Spanish or other).
  • You must reside within a commutable distance to an Anthem office.
  • Experience working with MS Word, Outlook and Excel, along with web-based applications, is required.

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 careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.


Share: mail

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.