Working for Anthem as a C.M.?

pfchang · Jun 12, 2015

There are many different divisions and types of Case Managers at Anthem and your experience can vary wildly, depending on the details of the position. I might provide more specific info to get info from people here.

Bluebolt · Jun 14, 2015

I'm looking mostly at the entry level Case Manager 1 positions. They have probably 40 locations with openings across the US. I have over 3 years of ICU experience (CVICU, Neuro, Cardiac, Medical and Surgical). We do morning rounds that include the interdisciplinary approach where I introduce and discuss the patient in a conference room to the attending physician, infectious disease physicians, other consulted MD's, usually all their PA's, pharmacist, Charge RN, Respiratory Therapist, Physical Therapist, Speech/Occupational Therapist, Dietician, Social Worker, Chaplain and Case Manager. This is the closest type of experience I have to what the Case Manager does (at least in the critical inpatient position).

I'm accustomed to questioning meds and diagnoses, types of therapy used, coordinating multiple healthcare professionals on a single patient, discharge planning (not as the case manager), communicating with families about care and progressive plan for the future, implementing and assessing my interventions.

I often work with the Case Manager to get in contact/communicate with (for example) a rehab facility for a post CVA patient who needs placement that receives Medicaid and a Trach/Vent/PEG. Of course I know that there are plenty of nuances about different insurances and coverage that I still don't know. I also don't know the ICD-10 codes and would have to learn those.

So would my background be suitable to transitioning into a Case Manager role and is there a specific type of position that is more suited for someone with Critical Care experience with their CCRN?

What would the typical daily duties for this new role be?

If there are 40 different locations posted is there any reason to pick a certain location over another?

How often do you leave your office to go assess patients in person and how do you keep your clinical skills current?

What is the typical salary to expect with my experience level?

I appreciate your help and look forward to your replies.

SummerGarden, BSN, MSN, RN · Jun 19, 2015

I'm looking mostly at the entry level Case Manager 1 positions. ... I have over 3 years of ICU experience (CVICU, Neuro, Cardiac, Medical and Surgical). We do morning rounds that include the interdisciplinary... I'm accustomed to questioning meds and diagnoses, types of therapy used, coordinating multiple healthcare professionals on a single patient, discharge planning (not as the case manager), communicating with families about care and progressive plan for the future, implementing and assessing my interventions. ...
So would my background be suitable to transitioning into a Case Manager role and is there a specific type of position that is more suited for someone with Critical Care experience with their CCRN?

Yes!!! I do not know about Anthem, but I am recruiting you for the hospital setting. If I were you I would talk to your current and former acute care setting employers. Specifically the Director and/or hiring managers of the Case Management department. I would ask them about an entry level (CM Level 1) position. I would also rework my resume to be worded as you worded this post. Do not just list skills, list that you actively have experience working on complicated discharge planning issues within the IDT.

What would the typical daily duties for this new role be?

Lots of post cover this but as you have seen, there are you get our case load/report, take care of what you can take care of early on (see some patients and perform assessments), then rounds, then work on your priorities... make arrangements for discharges and possibly transfers depending on your facility.

How often do you leave your office to go assess patients in person and how do you keep your clinical skills current?

Daily ... If you want to keep current with bedside skills you need to keep a bedside job Per Diem. Otherwise, your hands-on assessment skills may become rusty. On the other hand, your other assessment skills will not get bad and your skills regarding typical medical courses of treatment/patient care will not go bad because you will be involved with the over all care an treatment of the patient daily; just not hands on.

What is the typical salary to expect with my experience level?

Beginning/Entry Level CM for your area. You will not get paid for years of bedside work experience or your Critical Care Nursing Cert (which I encourage you to keep up anyway because you never know where your career will go). You get paid for years of CM experience along with CCM or other related certifications when you have years and the cert under your belt.

Bluebolt · Jun 20, 2015

Thanks for the pointers and advice on hospital inpatient setting CM. I appreciate your help! I'm curious if anyone works as a case manager outside the hospital setting? I've talked with CM at my hospital and work with them directly but I've got no knowledge or understanding of the typical day of a CM not in the inpatient setting.

RocknRollYogaRn · Jun 20, 2015

I work for Amerigroup which is the Medicaid division of Anthem here in Nevada. I am a case manager. I work 100% from home. I think that the most helpful experience I bring to the job is my experiences in various settings over my 20+ years of nursing most of it out of the hospital. Don't expect the pay to be high but the benefits of working from home is worth a lot in my opinion and the people who work at Amerigroup are an amazing bunch of professionals and just good people. Yes, I miss making more money but not the bull**** that I had to endure on a daily basis for that paycheck. Just my $.02.

Bluebolt · Jun 21, 2015

Yeah I've heard of the working from home CM jobs. I know for some people who maybe are home schooling or something like that it sounds great. I personally would go stir crazy if I worked out of my house. I'm a travel nurse currently so I shudder at the thought of how much I would have to drop my income to do CM.

SummerGarden, BSN, MSN, RN · Jun 23, 2015

Yes, a cut in pay occurs just about everywhere when new to CM jobs. On the other hand, after you get a year or two under your belt you can travel or work Per Diem and make more money! :)

Bluebolt · Jul 8, 2015

So no case managers on here who works for Anthem and knows anything about the typical day and typical pay as a new employee with less than 5 years experience?

CareManagerBSN · Aug 14, 2015

I just interviewed for a position as a Case Manager with Anthem. I have done outpatient Care Management (Internal Medicine Primary Care Office Nursing) for 4 years, and am a Certified Care Manager. The case load, from what I was told is approximately 60 patients (all telephonic of course), working in an office-setting (for this specific position). The hours are a little odd: CT 10:30am-7pm or 11:30am-8pm or 12:30pm-9pm. They did not provide a pay range yet in my interview process. I am wondering if anyone can review Anthem as a company??

CareManagerBSN · Aug 14, 2015

see above

NurseRoRo · Dec 20, 2015

I worked for Anthem un the past as a telephonuc case manager. i had a caseload of approx 65 members. They were a mix of short term and long term complex members either recently discharged or about to discharge from inpatient. My job was 100% from home. I attended rounds for the states in which I had members, presented those that are extra challenging or at the repquest of the medical director. I work 8a to 5p Mon thru Fri. My coworker communication is thru instant meaaaging and phone calls. Must know lots of community resources and be able to build rapport with members.