IDD/DD RN Nurse Case Manager - Richmond, Chesterfield or Henrico County, VA (Remote) PS6545

Anthem, Inc. Richmond, VA
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 health care. 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.

Location: Richmond, Chesterfield, or Henrico County, VA only - Remote from home

Responsible for performing care management within the scopeof licensure for our ID/DD members (Intellectual Disabilities/DevelopmentalDisabilities) with complex and chronic needs by assessing, developing,implementing, coordinating, monitoring, and evaluating assessments and careplans designed to optimize member health care across the carecontinuum. Performs duties telephonically or on-site such as at Members' homes, CSBs, day programs and hospitals.

Primary responsibilities include, but are not limited to:

* Responsible for ensuring member access toservices appropriate to their health needs.

* Conduct assessments to identify individual needsand a specific care management plan to address objectives and goals asidentified during assessment. This includes outreach to communityresources and working with special needs and behavioral needs specialists inthe region.

* Implement care plans by facilitatingauthorizations/referrals as appropriate within benefits structure or throughextra-contractual arrangements.

* Coordinate internal and external resources tomeet identified needs.

* Monitor and evaluate effectiveness of the caremanagement plan and modifies as necessary.

* Interface with Medical Directors and PhysicianAdvisors on the development of care management treatment plans.

* May assist in problem solving with providers,claims or service issues.

* Virginia residency required.

* Current, active and unrestricted RN license in the state of Virginia.

* Minimum of 3 years of clinical experience, including experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator role, Case Management role, or working with Medicaid, managed care and/or LTSS.

* Demonstrated experience working with the ID/DD population, waiver programs and community resource groups is required.

* Current or prior field/home health experience is preferred.

* You must be able to travel locally; this position requires a reliable vehicle, current auto insurance and clean driving record (mileage, tolls reimbursed)

* You must be competent in MS Office suite to include Word, Outlook and Excel, as well as be comfortable with computers in general (i.e. Apple products) since you will be entering assessments into an iPad and syncing the information with a Laptop.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at

EOE. M/F/Disability/Veteran.