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RN Nurse Case Manager I/II for Developmentally Disabled - Iselin, NJ 122792

Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.





Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.





Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine. 





Nurse Case Manager I/II for Developmentally Disabled -  Iselin, NJ 122792









This is an office-based position located at the NJ Health Plan, in Iselin, NJ.



This is a telephonic case manager position with the primary responsibility of performing initial assessments on members. No field work involved.





This Case Manager will assist families and their members with developmental



disabilities to obtain services and support based upon their medical and psychosocial needs. Responsible for performing care management within the scope of licensure for members with 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.







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.



· Assists in problem solving with providers, claims or service issues.





RN Nurse Case Manager I/II for Developmentally Disabled - Iselin, NJ 122792

Woodbridge Township, NJ
Full Time

Published on 08/14/2019