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Nurse Disease Management I, II or Senior-FEP-PS1433 in Richmond, VA at Anthem, Inc.

Date Posted: 2/12/2018

Job Snapshot

Job Description

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.
 
We have an opening for a Nurse Disease Management I, II or Sr. - FEP. The hiring manager will determine level of hire based upon the selected applicant's skillset relative to the qualifications listed for the position.    
 
The Nurse Disease Management will be responsible for outreach, enrollment and management of Disease Management members.  Provides education and coordination to address gaps in care for 5 managed conditions (Diabetes, Heart Failure, Coronary Artery Disease, Asthma and COPD) to ensure cost effective and efficient utilization of health services. Conducts assessment, planning, implementation, coordination, monitoring and evaluation of members. 
 
Nurse Disease Management I 
Responsible for participating in delivery of patient education and disease management interventions and for performing health coaching for members, across multiple lines, for health improvement/management programs for chronic diseases. Primary duties may include, but are not limited to:
Conducts behavioral or clinical assessments to identify individual member knowledge, skills and behavioral needs. Identifies and/or coordinates specific health coaching plan needs to address objectives and goals identified during assessments.
Interfaces with provider and other health professionals to coordinate health coaching plan for the member.
Implements and/or coordinates coaching and/or care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs.
Uses motivational interviewing to facilitate health behavior change.
Monitors and evaluates effectiveness of interventions and/or health coaching plans and modifies as needed.
Directs members to facilities, community agencies and appropriate provider/network.
 
Nurse Disease Management II
Responsible for participating in and delivery of more complex patient education and disease management interventions and performs health coaching for members, across multiple lines, for health improvement/management programs for chronic diseases. Primary duties may include, but are not limited to:
Conducts behavioral or clinical assessments to identify individual member knowledge, skills and behavioral needs.
Identifies and/or coordinates specific health coaching plan needs to address objectives and goals identified during assessments.
Interfaces with provider and other health professionals to coordinate health coaching plan for the member.
Implements and/or coordinates coaching and/or care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs.
Uses motivational interviewing to facilitate health behavior change.
Monitors and evaluates effectiveness of interventions and/or health coaching plans and modifies.
Directs members to facilities, community agencies and appropriate provider/network.
Serves as a resource to lower-leveled DM associates.
Refers member to catastrophic case management as appropriate.
 
Nurse Disease Management Sr.
Responsible for providing clinical expertise in design and delivery of the most complex patient education and disease management interventions and performs health coaching for members, across most lines, for health improvement/management programs for chronic diseases. Primary duties may include, but are not limited to:
Conducts behavioral or clinical assessments to identify individual member knowledge, skills and behavioral needs.
Identifies and/or coordinates specific health coaching plan needs to address objectives and goals identified during assessments. Interfaces with provider and other health professionals to coordinate health coaching plan for the member.
Implements and/or coordinates coaching and/or care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. Uses motivational interviewing to facilitate health behavior change.
Monitors and evaluates effectiveness of interventions and/or health coaching plans and modifies.
Directs members to facilities, community agencies and appropriate provider/network. Refers member to catastrophic case management as appropriate.
Assists with development of new programs and initiatives, leads departmental projects or participates on cross-functional teams.

Job Requirements

Nurse Disease Management I
  • Requires an AS/BS in nursing; 2 years of condition specific clinical or home health/discharge planning experience; or any combination of education and experience, which would provide an equivalent background.
  • Current unrestricted RN license in applicable state(s) required.
  • Prior case management experience preferred.
Nurse Disease Management II
  • Requires an AS/BS in nursing; 3 years of condition specific clinical or home health/discharge planning experience; or any combination of education and experience, which would provide an equivalent background.
  • Current unrestricted RN license in applicable state(s) required.
  • Prior case management experience preferred.
Nurse Disease Management Sr.
  • Requires an AS/BS in nursing; 5 years of condition specific clinical or home health/discharge planning experience; or any combination of education and experience, which would provide an equivalent background.
  • Current unrestricted RN license in applicable state(s) required.
  • Prior case management experience preferred. Prior disease management experience required to coordinate and manage multiple high priority responsibilities with chronically ill members.
  • Broad clinical knowledge base of disease processes with the ability to analyze, interpret and evaluate data and develop care management strategies required.
These positions can be located in St. Louis, MO; Indianapolis, IN; Richmond, VA; or Woodland Hills, CA
 
The hours for this position maybe an 8 hour shift between the hours of 11:00 am - 11:00 pm est Monday thru Friday.  Position may work remotely.
 
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 antheminc.com/careers. EOE. M/F/Disability/Veteran.

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