CareMore Care Management Manager I
DescriptionSHIFT: Day Job
CareMore Care Management Manager I
Location: Position will work primarily from home, with occasional travel to CareMore clinics.
Be part of an extraordinary team
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Build the Possibilities. Make an extraordinary impact.
CareMore is a proud member of the Anthem family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.
We are hiring a Manager I - Care More Care Management. Responsible for managing the implementation of clinical protocols and programs.
How you will make an impact:
- Manages quality improvement, resource management, cost containment, case management, and member and provider grievance resolution.
- Assists in managing department policies and procedures, clinical data analysis, ancillary contract implementation, and provider education.
- Assists in creating annual Case Management (CM) work plan, quarterly reports, and annual evaluations.
- Manages the implementation of CM programs and monitors and recommends modifications.
- Represents the Health Plan in vendor meetings.
- Attends meetings and medical management committees.
- Collaborates with local physicians to provide support for positive member outcomes.
- Evaluates CM system/clinical operation effectiveness and presents findings to management.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
- Requires an RN and minimum of 4 years of experience; or any combination of education and experience, which would provide an equivalent background.
- Current unrestricted RN license in CA required.
- For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position.
- BS in Nursing preferred.
- Leadership experience preferred.
- Case management experience 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.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.
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.