🌎
This job posting isn't available in all website languages

Manager I, Healthcare Management Services - Cary, North Carolina PS25210

📁
Medical
📅
PS25210 Requisition #
Your Talent. Our Vision. At Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. companyit’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.


Location:  This position oversees a team of outpatient RN Utilization Review Nurses, and is based in our Cary office.

Responsible for managing a team of physical and/or behavioral health practitioners responsible for coordinating member service, utilization, access, care management and/or concurrent review to ensure cost effective utilization of health, mental health, and substance abuse services for one or more member product populations of varying medical complexity ensuring the delivery of essential services that address the total healthcare needs of members. 

Primary duties may include, but are not limited to: 

Manages and oversees team responsible in case finding and coordinating cases that involve comorbid conditions. Coordinates service delivery to include member assessment of physical and psychological factors. Partners with providers to establish short and long term goals that meet the members' needs, functional abilities, and referral sources requirements. Identifies members with potential for high risk complications. Reviews benefit systems and cost benefit analysis. Evaluates medical, mental health and substance abuse service for cost containment. Supports program compliance and assists in identifying opportunities to improve the customer service and quality outcomes. Supports quality initiatives and activities, including adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting. Hires, trains, coaches, counsels, and evaluates performance of direct reports. 
Requires a BA/BS; 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background. 
Current active unrestricted RN, PA, LSW, LCSW, LPC, LMHC or other accepted license (as allowed by applicable state laws); and any other state or federal requirements that may apply is required. 
MSN, MPH, MPA, MSW or MBA with Health Care Concentration preferred.
Certified Case Manager Certification preferred.


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 please visit us at antheminc.com/careers.
AnEqualOpportunityEmployer/Disability/Veteran

Previous Job Searches

Activity Feed

28881
Job shares through Anthem, Inc.
Nagaraj Srinivasachar referred the Data Architect Exec Advisor position. 2 days ago
Sharath Chander Rao Gandra referred the Salesforce Systems Analyst II or Sr - PS23884 position. 3 days ago
sudhakar bodapati referred the Dir II Technology position. 4 days ago
Crystal Hunter referred the Implementation Support Specialist I - New York, NY (office-based)- PS25554 position. 5 days ago
Dhruti Majmudar referred the Analyst Sr/Consultant-Remote near multiple locations-PS24624 position. Aug 09, 2019

Similar Listings

Raleigh, North Carolina, United States

📁 Medical

Requisition #: PS24403

Raleigh, North Carolina, United States

📁 Medical

Requisition #: PS20689

Raleigh, North Carolina, United States

📁 Medical

Requisition #: PS24764

Supplier Registration Process

Anthem, Inc.'s supplier registration process will automatically enter your information into our prospective supplier database.

Anthem does not do business with persons or entities identified on the General Services Administration's List of Parties Excluded from Federal Programs and the HHS\OIG List of Excluded Individuals\Entities.

Anthem, Inc. Purchase Order Terms

Anthem's standard payment terms are net 50. Payment terms will be calculated from the invoice date, which should also reflect the date goods or services were received.

Anthem also offers various discount options that provide you with the opportunity for early payment and we are also encouraging our suppliers to participate in our electronic funds transfer (EFT) method of payment. The EFT method of payment will improve the efficiency of our payment processes and ensure that you are paid properly and on time.

Anthem, Inc. Supplier Registration Process

*Please Note: To complete the supplier registration process, you will leave antheminc.com and will be directed to the Ariba Network (AN) site. Once there please click on Register as New Supplier to complete the online registration form and follow the on-screen instructions.

Supplier Registration

Anthem, Inc. utilizes the Ariba Network to determine qualified suppliers that meet Anthem’s business need. Prospective suppliers should complete Ariba’s Supplier Registration Process.*

*Please Note: To complete the supplier registration process, you will leave antheminc.com and enter the Ariba Network (AN) site. Once there, please click on 'Register as New Supplier' on the left-hand side of the screen, complete the online registration form and follow the on-screen instructions.

Anthem does not do business with persons or entities identified on the General Services Administration's List of Parties Excluded from Federal Programs and the HHS\OIG List of Excluded Individuals\Entities.

What to expect next after registration

Anthem Inc.'s Procurement department will review your registration and additional materials. If our sourcing needs align with your goods or services, an Anthem Buyer will contact you to discuss next steps and other pertinent details. If there is no current need, your information will remain in our prospective supplier database for one year for processing against future requests.

Supporting Documents

Guidelines for Prospective Suppliers (PDF)

Company Policy and Procedures (PDF)

To obtain a copy of Anthem's Supplier Travel Guidelines, please send an email to TravelPoint@anthem.com.