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Nurse Case Mgr I - 11:30am - 8pm, Weekdays - Louisville Office

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Medical
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PS24879 Requisition #

 

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.

 

Work Hours: 11:30am - 8pm, Monday - Friday.. eligible for shift pay for the late hours worked.

 

Location: This position will be based in our Louisville, KY office for the first year. After successful completion of 1 year in position, there may be an opportunity to work@home.

 
The Nurse Case Manager I is responsible for performing 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. Performs duties telephonically for discharge planning. Primary duties may include, but are not limited to: 
  • Ensures member access to services appropriate to their health needs. 
  • 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. 
  • Negotiates rates of reimbursement, as applicable. 
  • Assists in problem solving with providers, claims or service issues. 

 

 

The Nurse Case Manager l requires:

  • BA/BS; 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background.
  • Current, active Kentucky RN license required.
  • Multi-state licensure is required.
  • Must be able to work 11:30am - 8pm, Monday - Friday.
  • Managed care/health insurance industry required.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 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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Actuarial

Program Overview

Our Actuarial Internship Program allows students to gain valuable experience in the actuarial field, as well as in a dynamic health care environment. Through actuarial careers with Anthem, Inc., you will have the opportunity to help drive the future of health care, by finding ways to make health care more affordable and more valuable to the public.

Highlights

  • Interns are assigned a mentor who will serve as an informal guide
  • Students present their projects to senior leadership in person and through live video conferencing
  • Students will gain experience working on a variety of real actuarial projects alongside actuaries of varying experience
  • Daily interaction with mentors and final evaluations provide two-way feedback and opportunities to discuss future employment interests

Qualifications

Successful candidates typically possess:

  • Current enrollment in an accredited college or university and planned continued enrollment after internship period
  • High GPA (or a combination of experience and GPA)
  • Participation in an actuarial science, math, or statistics program
  • Commitment to an actuarial career (participation in an actuarial club, math associations, attendance at actuarial conferences, etc.)
  • Adaptability
  • Rapid learning ability
  • Effective teamwork and written/verbal communication skills

Exams

It is not required that you have passed an exam to participate as an actuarial intern; however, we like to know that you plan on taking one during the current/upcoming school year.

Timeline and On-campus Events

  • Fall (Sept/Oct) – look for information sessions and on-campus interviews through your career center. If you do not see your campus listed, please apply to the job through our careers site by typing “Actuarial Intern” in the keyword search field

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