Managed Care Coordinator
Anthem
5,315 reviews
Tampa, FL 33607
Anthem
5,315 reviews
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Job details
Job Type
Full-time
Full Job Description Description
SHIFT: Day Job
SCHEDULE: Full-time
Managed Care Coordinator
Use only in markets where the state law and contract do not require Mgd Care Coordinators to be licensed.
• Responsible for overall management of members individual service plan within the scope of position, as required by applicable state law and contract.
• Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of members program needs.
• Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high risk complications) and coordinates those members cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
• Holistically coordinates needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of services.
• Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, and physicians. Identifies members that would benefit from expanded services.
Qualifications
Qualified candidates will meet one of the following at minimum:
• A Bachelor's (or higher) degree in a health or human services related field
• BA or BS in unrelated field and 2+ yrs. relevant experience
• LPN with 1+ yrs. of relevant experience
• A minimum of 2 years of case/disease management experience in Ryan White, PAC Waiver, or other community agency working directly with persons living with HIV/AIDS, behavioral health, or related health care populations.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.