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Anthem, Inc. Medical Management Specialist I in Roanoke, Virginia

Description

SHIFT: Day Job

SCHEDULE: Full-time

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.

Responsibilities:

  • The Medical Management Specialist I is responsible for providing non-clinical support to the Medical Management and/or Operations areas

  • Primary duties may include, but are not limited to: Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review)

  • Provides information regarding network providers or general program information when requested. May assist with complex cases

  • May act as liaison between Medical Management and/or Operations and internal departments. Maintains and updates tracking databases

  • Prepares reports and documents all actions

  • Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information

    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 Force, 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.

Qualifications

Requirements:

  • A high school diploma; 1 year of experience with an understanding of managed care or Medicaid/Medicare; or any combination of education and experience, which would provide an equivalent background

  • For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills

    REQNUMBER: PS57239

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