SHIFT: Day Job
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.
The LTSS Service Coordinator -working under the direction/supervision of
an RN, with overall responsibility for the member’s case, as required by
applicable state law and contract, contributes to the LTSS care coordination
process by performing activities within the scope of licensure including, for
example, assisting the responsible RN with telephonic or face-to-face
assessments for the identification, evaluation, coordination and management of
member’s needs, including physical health, behavioral health, social services
and long term services and supports.
* Assists responsible RN in identifying members for high risk complications. Obtains clinical data as directed by the responsible RN.
* Assists the responsible RN in identifying members that would benefit from an alternative level of care or other waiver programs.
* Provides all information collected to the responsible RN, who verifies and interprets the information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the member’s care plan to meet the member’s needs.
* Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by responsible RN, and in conjunction with the RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits.
* Decision making skills will be based upon the current needs of the member and require an understanding of disease processes and terminology and the application of clinical guidelines but do not require nursing judgment.
* Requires an LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law;
* 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background.
* Current, unrestricted LPN/LVN, LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s) required.
* Masters in Health/Nursing preferred.
* May require state-specified certification based on state law and/or contract
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