Nurse Case Manager I/II/Sr (Medicaid) - Pewaukee, WI - 68819SY
Location: Brookfield Wisconsin
Description: WellPoint is looking of Nurse Case Manager I/II/Sr (Medicaid) - Pewaukee, WI - 68819SY right now, this position will be placed in Wisconsin. More complete informations about this position opportunity please give attention to these descriptions. Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are de! dicated to improving the lives of the people we serve and the health of our communities.
Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.
This position will be onsite in the Pewaukee office and will be doing onsite facility/home visits as well.
Performs care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs. Primary duties may include, but are not limited to: Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. Implements care plan by facilitating authorizations! /referrals as appropriate within benefits structure or through! extra-contractual arrangements. Coordinates internal and external resources to meet identified needs. Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care management policies and procedures. Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to improving the lives of the people we serve and the health of our communities.
Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.
This position will be onsite in the Pewaukee office and will be doing onsite facility/home visits as well.
Performs care manageme! nt within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs. Primary duties may include, but are not limited to: Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. Coordinates internal and external resources to meet identified needs. Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. Assists in problem solving with providers, claims or! service issues. Assists with development of utilization/care managemen! t policies and procedures.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to WellPoint.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Thu, 13 Jun 2013 00:48:38 GMT
Apply Nurse Case Manager I/II/Sr (Medicaid) - Pewaukee, WI - 68819SY Here
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