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Anthem, Inc. LTSS Service Coordinator-Clinician in Jersey City, New Jersey

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.

$250 Sign On Bonus Offered

Location: The incumbent must reside in and cover Hudson, Passaic, and Bergen County and possibly some surrounding areas. You must be able to travel within your assigned territory daily and will work from home when not in the field. You will be in the field approximately 70% of your time or 3-4 days per week.

The LTSS Service Coordinator - Clinician while 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.

Qualifications

  • Requires an LSW 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 LSW in NJ required.

  • Masters in Health/Nursing preferred.

  • Able to travel locally in your own vehicle throughout the specified region (mileage reimbursed).

  • Field experience (home health, nursing home, etc.) preferred.

  • Medicaid, managed care, long term care knowledge preferred

  • Computer skills: MS Office (Word, Outlook, Excel)

  • You must be comfortable working on computers. You will be completing online assessments, inputting information into excel spreadsheets, and working with web-based applications. Inability to use the computer will hinder your success in this position.

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.

REQNUMBER: PS44274

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