Anthem, Inc. Manager I CareMore Care Management in Des Moines, Iowa
SHIFT: Day Job
Your Talent. Our Vision. At CareMore, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination. It’s 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 health care.
CareMore is a proven care delivery model for the highest-risk. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. We build and lead integrated, multi-disciplinary clinical teams to care for the most complex patients. We strive for excellence and have achieved significant and measurable improvement in total cost of care, clinical outcomes, and experience. As an Anthem subsidiary, we benefit from the scale and resources one of America’s largest managed healthcare organizations.
Hours: Monday to Friday 8 am - 5 pm Pacific Time
Responsible for assisting in developing and managing the implementation of clinical protocols and programs. Primary duties may include, but are not limited to:
Manages quality improvement, resource management, cost containment, case management, and member and provider grievance resolution.
Assists in developing and managing department policies and procedures, clinical data analysis, ancillary contract implementation, and provider education.
Develops and implements corrective action plans. 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 case management meetings and medical management committees.
Evaluates CM system/clinical operation effectiveness and presents findings to management.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires current unrestricted RN license in CA or ability to obtain.
4 years of Case Management experience and CCM preferred but not required;
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.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
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