Company Detail

Job Description

Software Engineer

United States

New

Information Technology

10 hours agoPost Date

22201178Requisition #

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Support maintenance of OneVision screens and MES interfaces within the client environment

CTG is a leading provider of digital transformation solutions and services that accelerate clients' project momentum and achievement of their desired IT and business outcomes. Our vision is to be an indispensable partner to our clients and the preferred career destination for digital and technology experts. CTG has operations in North America, South America, Western Europe, and India. For more information, visit www.ctg.com.

Our culture is a direct result of the people who work at CTG, the values we hold, and the actions we take. In other words, our people are the culture. It's a living, breathing thing that is renewed every day through the ways we engage with each other, our clients, and our communities. Part of our mission is to cultivate a workplace that attracts and develops the best people, reflected by our recognition as a Great Place to Work-certified company across many of our global operations.

CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

CTG is an Equal Opportunity and Affirmative Action Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. Our Affirmative Action program serves to promote occupational equality and diversity through good faith efforts. CTG is fully committed to promoting employment opportunities for members of protected classes.

Additional Information

• Job Function: Programming & Application Development

• Education Level: High School Diploma/GED (11 years)

• Work Remote: Yes

• Travel: No

Job Detail

• Company:
  CTG

Job Description

Business Intelligence Analyst

United States

New

Healthcare IT

9 hours agoPost Date

22201185Requisition #

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CTG is looking for a remote Tableau & Cognos Business Intelligence Analyst for a large Award-Winning Medical Center in California!

Project Duration:1 year initially

Project Location:Remote (California, PST)

Job Title:Tableau & Cognos BI Analyst

Description:Full-time (consulting position)

Job Summary: Join CTG, a Certified Best Place to Work Company, and work with our clients on enhancing their data analytics with a focus on data and Tableau reporting.

Responsibilities:

• Strong experience using Tableau (Cognos experience a plus) creating reports from blended data sources

• Ability to write complex formulas and reconcile data to the source system

• Ability to create instructions for multiple report consumers outlining how to trace reporting data back to the source system

• Strong troubleshooting skills

Required Skills:

• 5+ years’ experience in creating reports and dashboards

• Experience with Tableau is required and Cognos is nice to have

• Strong Oracle database experience

• Certifications in Tableau and/or Oracle desired

• Prefer knowledge of health systems

CTG is a leading provider of digital transformation solutions and services that accelerate clients' project momentum and achievement of their desired IT and business outcomes. Our vision is to be an indispensable partner to our clients and the preferred career destination for digital and technology experts. CTG has operations in North America, South America, Western Europe, and India. For more information, visit www.ctg.com.

Our culture is a direct result of the people who work at CTG, the values we hold, and the actions we take. In other words, our people are the culture. It's a living, breathing thing that is renewed every day through the ways we engage with each other, our clients, and our communities. Part of our mission is to cultivate a workplace that attracts and develops the best people, reflected by our recognition as a Great Place to Work-certified company across many of our global operations.

CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

CTG is an Equal Opportunity and Affirmative Action Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. Our Affirmative Action program serves to promote occupational equality and diversity through good faith efforts. CTG is fully committed to promoting employment opportunities for members of protected classes.

Additional Information

• Job Function: Application Management & Support

• Education Level: High School Diploma/GED (11 years)

• Work Remote: Yes

• Travel: No

Job Detail

• Company:
  CTG

Job Description

Epic Cadence/ ADT Analyst

United States

New

Healthcare IT

11 hours agoPost Date

22201187Requisition #

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Come join us and grow your career with CTG! Apply with CTG for this exciting opportunity!

Job Title:Cadence Analyst

Location:Remote

Duration:11 Months

Summary:

• Support requests that involve general Epic analysis and support as well as some complex issues in respect to workflows and features, functions, and configuration of the Epic build.

• Qualified candidate will need to show a willingness to be a team player and apply application implementation best practices.

• Provide Epic application support (work tickets, service/change request, routine maintenance), while client focuses on important initiatives.

• Position is remote, but Knowledge Transfer may occur onsite or remotely.

• Documentation of responsibilities, How To’s and any requirements of your specific role on this project is expected. Initial document will be created during the knowledge transfer period and maintained through the life of the engagement.

Requirements:

• Must have strong Epic Cadence build and optimization experience

• Current Epic Cadence, Grand Central / Prelude certifications

• Prior consulting experience is preferred.

• Excellent communication is required.

• Experience with incident tickets, projects, upgrades, Nova Notes, Sherlock tickets

Additional Information

• No third party resumes will be accepted

• Drug testing and/or other employment-related inquiries may be conducted

• All interested individuals MUST be able to work on a W2 Tax basis (no C2C or third party vendors)

• CTG will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws

• CTG is an Equal Employment Opportunity employer

• CTG is an E-Verify Company

To be considered for this opportunity, please apply directly through our website by clicking the link below or email your Word version resume toRachel.Bruso@ctg.com

CTG is a leading provider of digital transformation solutions and services that accelerate clients' project momentum and achievement of their desired IT and business outcomes. Our vision is to be an indispensable partner to our clients and the preferred career destination for digital and technology experts. CTG has operations in North America, South America, Western Europe, and India. For more information, visit www.ctg.com.

Our culture is a direct result of the people who work at CTG, the values we hold, and the actions we take. In other words, our people are the culture. It's a living, breathing thing that is renewed every day through the ways we engage with each other, our clients, and our communities. Part of our mission is to cultivate a workplace that attracts and develops the best people, reflected by our recognition as a Great Place to Work-certified company across many of our global operations.

CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

CTG is an Equal Opportunity and Affirmative Action Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. Our Affirmative Action program serves to promote occupational equality and diversity through good faith efforts. CTG is fully committed to promoting employment opportunities for members of protected classes.

Additional Information

• Job Function: Healthcare Application Management & Support

• Education Level: Bachelor's Degree (16 years)

• Work Remote: Yes

• Travel: No

Job Detail

• Company:
  CTG

Job Description

$5,000 SIGN ON BONUS FOR EXTERNAL CANDIDATES

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The regionally based, locally hired Behavioral Health Advocate (BHA) will be the single point of contact for children, youth, caregivers, CPS, and related agencies to coordinating a child or youth in our Virginia program. The navigators are required to have experience working within the foster care system and have knowledge of services used by foster care children and youth, especially behavioral health services. The BHA will meet with CPS, and they will complete assessments, attend internal clinical rounds, make recommendations to the child and family team, and make certain essential medical and behavioral health services are provided to children and youth. The navigators will reach out to providers when needed and will update information on the EHR.

Behavioral Health Advocates are responsible for coordinating and managing medical and behavioral health services delivered to youth who are in foster care. The BHA has experience working within the foster care system and also have knowledge of services utilized by foster care youth, especially behavioral health services. The BHA serves as the primary point of contact for the youth, their family, the state child welfare contractor, foster parents or group home placements and network providers.

*These positions will be located primarily in the following areas*

Arlington, Alexandria, Fairfax, Manassas, Prince William, Charlottesville City, Richmond, Chesterfield, Bristol City, Abingdon

This is a work at home position with travel up to 25-50% in local areas in the Commonwealth of VA (travel will not be required until Covid 19 restrictions are lifted). Must live and be independently licensed in the Commonwealth of VA.

Schedule is Monday - Friday, days.

If you are located in Virginia, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Providing care coordination and serving as single point of contact for children, family, state foster care contractor, and/or the Department of Juvenile Justice (DJJ)

• Conducting assessments of child's needs in collaboration with identified supports

• Developing a plan of care in collaboration with the youth, family, state foster care contractor and foster care placement to address member needs

• Reviewing and revising plan of care as needed based upon the needs of the member

• Providing outreach to network providers to ensure the delivery of appropriate services to meet member needs and the coordination of services among providers

• Working collaboratively with service providers, families, state child welfare contractor and child placing agencies to identify and access resources to meet the needs of members and support foster care placements

• Working with network providers to ensure timely access to services and coordinate service needs

• Providing outreach and coaching to members, families and foster care placement to encourage and promote treatment and service adherence

• Working with the member, family, state foster care contractor and foster care placement to identify and address gaps in services

• Responding promptly to emerging issues that impact services to the youth

• Provide education to members, families and foster care placements regarding relevant medical and behavioral topics

• Seeking consultation and support from other members of core and extended care team as needed such as RN, Medical Director, Provider and Community Liaisons

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., or an RN with 2+ years of experience in behavioral health

• Current, unrestricted, independent VA License (LCSW, LMFT, RN, LPC, LP)

• 2+ years of experience in behavioral health

• Experience working with children, youth and young adults in foster care or juvenile justice

• Demonstrated understanding and experience in trauma informed care and working with a system of care

• Care planning and care management experience

• Proficient with Microsoft Office based applications and the ability to learn in a web based virtual environment

• Ability to travel up to 25% of the time in VA once Covid 19 restrictions are lifted

• Access to high-speed internet from home (Broadband Cable, DSL, Fiber) and a dedicated workspace from home

• Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance

Preferred Qualifications:

• Experience working with youth who have serious behavioral health needs

• Experience working in a wraparound program

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

*PLEASE NOTE* The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (-Internal Candidates-) are not eligible to receive a sign on bonus.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Job Detail

• Company:
  UnitedHealth Group

Job Description

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Positions in this function conduct analyses of Encounter SQL database objects and support mapping processes from an Encounter database using HIPAA Compliant Implementation Guide (IG) and Customer Companion Guide (CG) Transaction documentation and/or other proprietary formats to meet Customer/client requirements as well as all associated documentation.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Demonstrate and apply knowledge of medical and/or behavioral health claims and general encounter processing and management best practices

• Demonstrate and apply intimate knowledge of HIPAA transaction guides, data elements and use requirements

• Demonstrate and apply knowledge of federally mandated Companion Guide guidelines and their use

• Demonstrate and apply basic relational database concepts and familiarity

• Conducts/updates/manages analyses and document transaction requirements based on Implementation Guide, Companion Guides, and proprietary format instructions

• Identifies data gaps and manages remediation of same

• Assists in the development/creation/documentation of data maps from SQL to HIPAA/proprietary transactions

• Participate in QA of mapping/translations prior to release

• Conducts research as needed using a variety of SQL, XML, EDI, and file editing tools such as Microsoft SQL Server Management Studio, XMLSpy, UltraEdit

• Assists data and report analysts in developing data validation routines

• Acts as primary liaison between ENCOUNTER and Customer/client production personnel

• Demonstrate and apply a strong attention to detail

• Creates various work products using standard software packages (Word, Excel, Visio)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Bachelor's degree or equivalent

• 4+ years of experience with health care claims data

• 2+ years of experience of MS Excel, Word, Visio

• 1+ years of experience with SQL

Preferred Qualifications:

• Experience working as a Business Analyst

• Behavioral Health Medicaid encounter or claims systems/data experience

• Experience with reporting tools such as SSRS & Tableau

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum . Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut/Nevada residents is $72,800 to $129,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Detail

• Company:
  UnitedHealth Group

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team!

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse.

Primary duties may include, but are not limited to:

• Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. Reviews and conducts an analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations and continue to the next step in the claims lifecycle.

• Researches new healthcare-related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends, and changes in laws/regulations.

• Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern.

• Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.

Qualifications

Requirements:

• Requires a AA/AS and a minimum of 1 year of related medical coding/auditing experience; or any combination of education and experience, which would provide an equivalent background.

• Must achieve coding certification (CPC, CCS, CPMA) within 6 months of starting in this position.

Preferred Qualifications:

• Knowledge of ICD-10 and CPT/HCPC coding guidelines and terminology is a plus.

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS71557-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Location: Remote

Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Build the Possibilities. Make an extraordinary impact.

Responsible for providing day-to-day guidance, support, and leadership for IngenioRX (Pharmacy) under the guidance of a Medical Director. May be responsible for supporting one or more Medical Directors in ensuring clinical integrity of broad and significant clinical programs. May perform clinical review.

How you will make an impact:

• Participates in a physician on-call rotation for a 24x7 unit.

• May provide clinical guidance for programs.

• Supports clinicians to ensure timely and consistent responses to members and providers.

• Conducts peer-to-peer clinical reviews with attending physicians or other ordering providers to discuss review determinations, and patients' office visits with providers and external physicians.

• May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.

• May assist in the practitioner appeal reviews, appropriateness criteria reviews, medical technology assessments, setting and implementing QI initiatives, and practitioner/provider credentialing.

• Under direction, may be responsible for the administration of medical services for company health plans including medical policies.

• Serves as a resource and consultant to other areas of the company.

• May interpret existing medical policy.

• May be required to represent the company to external entities and/or serve on internal and/or external committees.

Qualifications

Minimum Requirements:

• Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).

• Must possess an active unrestricted medical license to practice medicine or a health profession.

• Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US.

• Minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.

• Must be willing to work on a rotation supporting a 24X7 operation.

• Weekend work will be required, averaging every 8th weekend and rotating holidays.

• Must be willing/able to work outside of standard hours to complete daily case load.

  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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

  REQNUMBER: PS71836-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for defining and managing the scope of Business Systems projects.

Primary duties may include, but are not limited to:

• Defines functional, usability, reliability, performance and support requirements of a system.

• Creates and performs feature testing and determines environmental needs.

• Provides the link between the technical and business views of the system by ensuring that the technical solutions being developed will satisfy the needs of the business.

• Partners with business , architecture and infrastructure and oversees all service levels to ensure business area satisfaction.

• In depth knowledge of tools utilized.

• Works with the IT learning organization to mentor and assist in training initiatives and performs estimates for application functionality enhancements.

• Proactively works with stakeholders to identify future system opportunities and enhancements.

• Interact with stakeholders to elicit and understand business requirements, functional/process design and simplify requirements and document using various requirements gathering tools (MS Visio, JIRA). Perform detailed analysis of current and to be as-is state of business process, and identify potential opportunities of automation.

• Develops use cases.

Qualifications

Minimum Qualification:

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years' experience in a variety of technologies, documenting requirements and/or building test cases; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Business Analyst or Business Systems Analyst certifications strongly preferred.

• Experience with mainframe computer, hardware and operating systems and the impacts of changes in the systems stream, testing/product quality processes, tools and methods strongly preferred.

• Experience with Rational tools, Six Sigma or other process improvement training strongly preferred.

• Experience with PEGA or Salesforce platform strongly preferred

• Experience with health care industry strongly preferred

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed 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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70888-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

National Government Services is a proud member of Anthem's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.

Location: Work@Home but must be within a 1-hour commute to an Anthem /Amerigroup office and must be able to work within the hours listed below.

Work Hours: You may reside in any time zone but must be able to work 9 am - 6 pm EST, Monday - Friday and rotating 10 am - 7 pm EST a few times a month.

How you will make an Impact:

Responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high-quality, cost-effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards accurately interpreting benefits and managed care products and steering members to appropriate providers, programs or community resources. Works with medical directors in interpreting appropriateness of care and accurate claims payment. May also manage appeals for services denied.

Primary duties may include, but are not limited to:

• Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.

• Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process.

• Collaborates with providers to assess member's needs for early identification of and proactive planning for discharge planning.

• Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications.

• Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.

• Serves as resource to lower-leveled nurses and may participate in or lead intradepartmental teams, projects, and initiatives.

Qualifications

Minimum Qualifications:

• Requires current active unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States and minimum of 2 years acute care clinical experience.

Preferred Skills, Capabilities, and Experiences:

• 3 years acute care clinical experience or case management, utilization management or managed care experience; or any combination of education and experience, which would provide an equivalent background.

• Knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products strongly preferred.

• Prior managed care experience strongly preferred.

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70751-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for translating moderately complex and varied business needs into application software requirements. Possesses full technical knowledge of most phases of systems and business analysis and is able to consider the business implications of the application of technology to current and future business environments.

Primary duties may include, but are not limited to:

• May lead teams of analysts assigned to complex projects.

• Determines specific business application software requirements to address complex and varied business needs.

• Analyzes and designs solutions to address complex and varied business needs.

• Consults with business partners concerning application and implementation of technology.

Qualifications

Minimum Requirements

• Requires a BA/BS and minimum of 8 years business analysis experience, which should include analysis and project management; or any combination of education and experience which would provide an equivalent background. Knowledge of systems capabilities and business operations is strongly preferred.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS71249-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Location: Remote

Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Build the Possibilities. Make an extraordinary impact.

The IngenioRx Specialty team is looking for a Director Clinical Pharmacy Strategies who will be responsible for ideation, development, management and oversight of utilization management (UM) initiatives for specialty drugs. This individual will collaborate with a team of cross functional leaders to drive solutions that align with business unit and organizational goals .

How you will make an impact:

• Ownership of clinical UM program such as Prior Authorization, Step Therapy, Dose Management, Channel management to drive superior clinical outcomes for members while managing costs.

• Establishes and executes clinical interventions and cost of care programs.

• Leads the creation of solutions to promote business growth and client retention.

• Demonstrate a deep understanding of market dynamics and operational elements of Specialty drug management, Establish strong relationships to affect change withing a highly-matrixed organization.

• Manage budget and support cost management targets. Hire, train, coach, counsel, and evaluate performance of direct reports.

Qualifications

Minimum Requirements:

• Requires a PharmD, RPh or MPh

• Minimum of 5 years of managed care experience; or any combination of education and experience, which would provide an equivalent background.

• Current pharmacist license required.

• Requires BS in Pharmacy.

Preferred Qualifications:

• Experience with Medical Specialty drug management.

• Strong oral, written, interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

• Client, Sales, and Account Management experience.

• Ability to work effectively across teams.

• Previous Management/Leadership experience.

  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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

  REQNUMBER: PS70209-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, highperformance culture that empowers you to make an impact?

Your Talent. Our Vision. At Anthem, Inc., it'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 health care.

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 care companies and a Fortune Top 50 Company.

Utilization Management Representative II

Responsible for managing incoming calls, including triage, opening of cases and authorizing sessions.

Work Schedule:

7:30am - 4:30 pm M - F Pacific Standard Time 9:30am - 6:30 pm M - F Central Standard Time

Primary duties may include, but are not limited to:

• Managing incoming calls or incoming post services claims work.

• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.

• Obtains intake (demographic) information from caller.

• Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given.

• Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care.

• Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.

• Verifies benefits and/or eligibility information.

• May act as liaison between Medical Management and internal departments.

• Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process.

Qualifications

Requirements:

• Requires HS diploma or equivalent and a minimum of 2 years customer service experience in healthcare related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background.

Preferred:

• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

• Certain contracts require a Master's degree.

  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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

  REQNUMBER: PS71986-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

The Cyber Security Senior Advisor - Detection Engineering (SIEM Content / Use Case Development) develops, recommends, and implements enterprise information security policies, technical standards, guidelines, procedures, and other elements of an infrastructure necessary to support information security in compliance with established company policies, regulatory requirements, and generally accepted information security controls. Responsible for maintaining current threat management capabilities that support our 24/7 Cyber Security Operations Center. This position will be developing and maintaining threat detection content across multiple security platforms that are operationalized by the Cyber Security Operations Center.

Primary duties may include, but are not limited to:

• Develop SIEM and Security Use Case Logic (Detection Engineering) for security threat models

• Conduct threat hunting exercises using industry best practices

• Document standard practices for metrics collection and reporting

• Maintain and develop documentation for CSOC use cases

• Align work products to Mitre ATT&CK framework and apply detection opportunities driven by threat hunting and threat intelligence.

• Development, testing, and management of CSOC use cases.

• Creation of custom logic to detect unique or previously undetectable attacks on Anthem's information assets.

• Deliver recommendations to close identified security gaps.

• Develop solutions to manage data in a cross-platform environment leveraging scripting and automation.

• Maintain accurate records of signal and detection logic in EDR, IDS, SIEM.

Qualifications

Minimum Requirements:

• Requires BS/BA in information Technology or related field of study and a minimum of 8 years experience in systems administration and security aspects of information systems, access management and network security technologies, network communications, computer networking, telecommunications, systems development and management, hardware, software, data, and people; experience with multiple technical and business disciplines required; requires broad-based experience to plan and design highly complex systems; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Security Certifications: CISSP and other advanced technical security certifications (e.g. Information Systems Security Architecture Professional, Information Security Engineering Professional, Certification and Accreditation Professional, or equivalent certifications) strongly preferred.

• EDR Signal development SIEM content management.

• Development background working with a code repository and managing content programmatically.

• Proficient in scripting languages and API usage (python, javascript, powershell, yara).

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS71364-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be a Part of an Extraordinary Team!

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Business Analyst II

Location : Remote opportunity-all locations to be considered.

This is an opportunity to join a growing team of associates within DBG (Diversified Business Group). Our team is responsible for identifying claims processing issues on WGS through data mining and then creating business requirements documents (BRD) to assist with creation of algorithms that will contribute to cost of care savings and total program savings. These positions will primarily perform WGS tasks in conjunction with the pre-pay initiative project for Datamining and Overpayments (DMO).

How you will make an Impact;

• Analyzes business needs to determine optimal means of meeting those needs.

• Assessing overpayment opportunity by reviewing WGS claim samples.

• Accessing provider contracts, company claims policies and coding guidelines to support prevention opportunities.

• Partners closely with query data analysts to create algorithms that will identify overpayments for prevention.

• Develops and maintains collaborative relationships with query developers, business owners and partners as well as DBG consultants and analysts.

• Manages and prioritizes own work based on business needs.

• Researches leads to identify additional overpayment savings opportunities.

• Develops Business Requirement Documentation (BRD) and completes UAT and coordinates PNP (process and procedure) documentation, involving those in and outside the business unit.

• Collaborates, provides guidance to team members and serves as a resource for the team.

• Identifies process improvement opportunities that result in increased savings.

Qualifications

Minimum Requirements:

Requires a BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Commercial claims experience

• Experience with WGS

• Advanced skill level with MS Excel (pivot tables, formulas, V-lookup)

• Must possess strong analytical and problem-solving skills with research-oriented approach; strong written, verbal and interpersonal communication skills are required

• Ability to manage multiple projects in various stages to completion

• Demonstrated meeting facilitation skills

• Knowledge of systems capabilities and business operations is strongly preferred.

• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

  If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.

  Applicable to Colorado Applicants Only

  Annual Salary Range*: $56,080 - $70,100

  Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

  • The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or

  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.

  The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.

  Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

  REQNUMBER: PS71485-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team:

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a lager purpose and an evolving, high-performance culture that empower you to make an impact?

This position can be filled at the Engineer I, II or III level. The hiring manager will determine the level, based on the candidate's experience and background.

Please note: The Engineer I position is eligible as an entry level role where recent coursework can be included as experience.

Build the possibilities. Make an extraordinary impact:

Engineer I:

Responsible for end to end application, system development and maintenance on single product or multiple smaller less complex technology platforms within an assigned client group, business unit or corporate department.

Engineer II:

Responsible for end to end application, system development and maintenance on medium or semi complex technology platforms within assigned client group, business unit or corporate department.

Engineer III:

Responsible for the delivery of end to end system development and maintenance on complex technology systems within assigned client group, business unit or corporate department.

How you will make an impact:

Engineer I:

• Works to develop knowledge of enterprise technology tools, resources, processes and systems.

• Works to develop relationships with the internal or external stakeholders to understand business and technical requirements.

• Will learn end to end IT engineering and change request process.

• Creates exhibits and other support materials as necessary.

• Assists with documenting less complex business and technical requirements for coding on system components.

• Assists in developing unit test plans while given specific tasks to support implementation.

• Works on developing testing best practices.

• Assists with provide on-call support and monitoring systems as needed.

• May assist in facilitating small groups on peer code reviews.

• May participate in vendor evaluations.

Engineer II:

• Writes correct and clean code with limited guidance while ensuring following best practices.

• Partners with internal and/or external stakeholder to better understand business requirements.

• Analyzes and classifies semi-complex change request and identifies and documents possible system code enhancements.

• Participates in developing application scope and objectives and preparing functional and/or technical specifications.

• Partner with designers and other web team members to better understand and apply the right marketing focused content.

• Codes and maintains semi-complex components of information systems.

• Develops and performs system testing and fixes defects identified during testing and re-executes unit tests to validate results.

• Understand testing best practices.

• Participates in integrating activities with other IT departments for successful implementation and support of project efforts.

• Develops a General understanding of how the work fits in to the larger project and identifies problems or issues in requirements.

• Provides on call support and monitors the system for semi-complex issues as needed.

• Facilitates small group design sessions or code reviews and participates in vendor evaluation.

Engineer III:

• Development on medium to large complex customer technology platforms or architectures.

• Maintains active relationships with internal and/or external stakeholder to develop business requirements.

• Analyzes and classifies complex change request and identifies and documents possible system code enhancements.

• Demonstrates knowledge of industry trends, our products and infrastructure.

• Collaborates with engineers and graphic designers, analyzes and classifies complex change request and reviews and evaluates possible enhancements.

• Works with development team to develop and define application scope and objectives and prepare functional and/or technical specifications.

• Analyzes and evaluates detailed business and technical requirements.

• Understands the product and analytics and drive requirements that take into account stakeholders needs.

• Identifies problems/risks.

• Codes and maintains complex components of information systems.

• Mentors others on coding standards and performs code reviews.

• Reviews test cases and advises QA on adjacent code/regression impact.

• Develops and performs system testing and fixes defects identified during testing and re-executes unit tests to validate results.

• Aids in integrating activities with other IT departments for successful implementation and support of project efforts.

• Provides on call support and monitors the system and identifies system deficiencies.

Qualifications

Minimum Requirements:

Engineer I:

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study.

• Requires experience working on one platform, one database and/or one system language.

• Business application experience strongly preferred.

Engineer II:

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 1 year experience on one platform; or any combination of education and experience, which would provide an equivalent background.

• Multi database, multi language or multi business application strongly preferred.

Engineer III:

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 3 years experience on one platform, multi database, multi language or multi business application; or any combination of education and experience, which would provide an equivalent background.

• Experience mentoring others, leading small projects and providing troubleshooting support is strongly preferred.

Preferred Skills, Capabilities and Experiences:

• Experience with Informatica is preferred.

• Experience with SQL Server and querying is preferred.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. Please Note: Associates in this job working from a California location are eligible for overtime pay based on California employment law.

Please Note: Associates in this job working from a California location are eligible for overtime pay based on California employment law.

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70375-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Program Manager Schedule: Monday-Friday; 8am-5pm PST Location: Remote with 10% travel-Must be within an hour of an Anthem office

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving high-performance culture that empowers you to make an impact?

Duties & Responsibilities Responsible for the development and ongoing management of one or more multi-year external client facing programs within a business unit. Program managers typically support business strategies through an integrated portfolio of external client facing projects or initiatives. A program manager may have responsibility for a piece of a larger enterprise/regional external client facing program. Primary duties may include, but are not limited to: - Manages and coordinates the development, approval, implementation and compliance of on-going external client facing programs; develops program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day to day external client facing business issues. - Researches applicable subject matter practices and remains aware of industry trends. - Manages external client facing relationships and partners with corporate and regional business areas. - Coordinates training related to external client facing program; develops program success measures and performs periodic assessments of program success.

Qualifications

Requirements - Requires a BA/BS - Minimum of 5 years external client facing experience in program/project management; or any combination of education and experience, which would provide an equivalent background.

Preferences - Graduate degree preferred. - Project management certification - Medicare, Stars quality and /or Health Plan / Medical Group experience

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS71328-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Nurse Case Manager I Location: W@H Hours: 11:30-8:00 pm EST preferred with 10% differential; however, Day shift is available but position will be required to work 2 shifts of 11:30-8:00 pm EST shifts/month. Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change.

Build the Possibilities. Make an extraordinary impact. At Anthem, Inc., emphasizing the importance of health and wellness among our members means healthy living as well for our employees. That's why we seek RN professionals who embody our commitment to living well, who share a passion to influence others and advocate healthy living. The encouragement our nurse health coaches provide to our members positively impacts healthy life choices and provides a sense of well-being that is immeasurable.

HOW YOU WILL MAKE AN IMPACT:

• Responsible for performing care management within the scope of licensure for members with complex and 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 or on-site such as at hospitals for discharge planning.

• 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.

• Negotiates rates of reimbursement, as applicable.

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

Qualifications

QUALIFICATIONS: MINIMUM REQUIREMENTS: Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state(s) required. PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: Previous Case Manager experience is preferred. Previous oncology experience preferred. 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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS71515-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team!

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change.

Do you want to be part of a larger purpose and an evolving high-performance culture that empowers you to make an impact?

Responsible for the development and ongoing management of one or more multi-year external client-facing programs within a business unit. Program managers typically support business strategies through an integrated portfolio of external client-facing projects or initiatives. A program manager may have responsibility for a piece of a larger enterprise/regional external client-facing program.

Primary duties may include, but are not limited to: - Manages and coordinates the development, approval, implementation and compliance of ongoing external client-facing programs; Develops program budget; Ensures program meets its stated objectives. - Provides subject matter expertise in response to day-to-day external client-facing business issues. - Research applicable subject matter practices and remains aware of industry trends. - Manages external client-facing relationships and partners with corporate and regional business areas. - Coordinate training related to external client-facing program; develops program success measures and performs periodic assessments of program success.

Qualifications

- Requires a BA/BS and a minimum of 5 years of external client-facing experience in program/project management; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications

- G&A experience, its greatly preferred - Graduate degree - Project management certification

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.

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.

Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS71107-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for developing and executing complex data mining analyses, which involves the design and execution of programs to extract data.

Primary duties may include, but are not limited to:

• Develops and executes data mining analyses. Uses program languages to extract data.

• Develops new and standard reports utilizing data warehouse information.

• Programs and writes queries and reports.

• Establishes and maintains strong knowledge of data warehouse database design, data definitions, system capabilities, related programming languages, and data integrity issues.

• Develops and supports data warehouse-related applications for business areas requiring design and implementation of database tables.

• Conducts training on use of applications developed.

Qualifications

Minimum Qualification:

• Requires a BS/BA degree and a minimum of 2 years related analytical experience; or any combination of education and experience which would provide an equivalent background. PC, spreadsheet, and database skills strongly preferred. Experience in standard Business Information tools and programming/query languages required.

  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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

  REQNUMBER: PS71442-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Build the Possibilities. Make an extraordinary impact.

• This is a remote, work from home position.

  How you will make an impact as a Grievance/Appeals Representative I:

  Responsible for reviewing, analyzing and processing claims in accordance with policies and claims events to determine the extent of the company's liability and entitlement. Primary duties may include, but are not limited to:

• Conducts investigation and review of customer grievances and appeals involving provision of service and benefit coverage issues. Contacts customers to gather information and communicate disposition of case; documents interactions.

• Generates written correspondence to customers such as members, providers and regulatory agencies.

• Performs research to respond to inquiries and interprets policy provisions to determine the extent of company's liability and/or provider's/beneficiaries entitlement.

• Responds to appeals from CS Units, Provider Inquiry Units, members, providers and/or others for resolution or affirmation of previously processed claims.

• Ensures appropriate resolution to inquiries, grievances and appeals within specified timeframes established by either regulatory/accreditation agencies or customer needs.

• Identifies barriers to customer satisfaction and recommends actions to address operational challenges.

  How you will make an impact as a Grievance/Appeals Representative II:

  Responsible for reviewing, analyzing and processing policies related to claims events to determine the extent of the company's liability and entitlement. Primary duties may include, but are not limited to:

• Conducts investigation and review of customer grievances and appeals involving provision of service and benefit coverage issues.

• Contacts customers to gather information and communicate disposition of case; documents interactions.

• Generates written correspondence to customers such as members, providers and regulatory agencies.

• Researches administrative or non-clinical aspects of the appeal, e.g. eligibility, benefit levels, overall adherence to policies and practices.

• May make decision on administrative appeals where guidelines are well documented and involve limited discretion.

• Prepares files for internal or external review by analysts, medical staff or outside consultant.

• Triages clinical and non-clinical inquiries, grievances and appeals, prepares case files for member grievance committees/hearings.

• Summarizes and presents essential information for the clinical specialist or medical director and legal counsel.

Qualifications

Minimum Requirements for a Grievance/Appeals Representative I:

• High school diploma or GED equivalent

• Minimum of 1 year experience in health insurance business including customer service experience; or any combination of education and experience which would provide an equivalent background.

  Minimum Requirements for a Grievance/Appeals Representative II:

• High school diploma or GED equivalent

• Minimum of 2 years experience in customer service, preferably in a managed care environment, medical office, or health insurance; or any combination of education and experience which would provide an equivalent background.

  Preferred Skills, Capabilities and Experiences for a Grievance/Appeals Representative I:

• Good verbal and written communication, organizational, interpersonal skills and PC proficiency strongly preferred.

  Preferred Skills, Capabilities and Experiences for a Grievance/Appeals Representative II:

• Ability to organize work, set and manage multiple priorities in a time sensitive manner is strongly preferred.

• Good oral and written communication skills, basic word processing, data base management, spreadsheet skills, PC proficiency and claims knowledge strongly preferred.

  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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.

  Applicable to Colorado Applicants Only

  Hourly Pay Range for Grievance/Appeals Analyst I*: $17.85/hr - $23.42/hr

  Hourly Pay Range for Grievance/Appeals Analyst II*: $18.04/hr - $23.68/hr (Min - MRP)

  Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

  • The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or

  Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

  REQNUMBER: PS70834-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for defining and managing the scope of Business Systems projects.

Primary duties may include, but are not limited to:

• Defines functional, usability, reliability, performance and support requirements of a system.

• Creates and performs feature testing and determines environmental needs.

• Provides the link between the technical and business views of the system by ensuring that the technical solutions being developed will satisfy the needs of the business.

• Partners with business , architecture and infrastructure and oversees all service levels to ensure business area satisfaction.

• In depth knowledge of tools utilized.

• Works with the IT learning organization to mentor and assist in training initiatives and performs estimates for application functionality enhancements.

• Proactively works with stakeholders to identify future system opportunities and enhancements.

• Interact with stakeholders to elicit and understand business requirements, functional/process design and simplify requirements and document using various requirements gathering tools (MS Visio, JIRA). Perform detailed analysis of current and to be as-is state of business process, and identify potential opportunities of automation.

• Develops use cases.

Qualifications

Minimum Qualification:

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years' experience in a variety of technologies, documenting requirements and/or building test cases; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Business Analyst or Business Systems Analyst certifications strongly preferred.

• Experience with mainframe computer, hardware and operating systems and the impacts of changes in the systems stream, testing/product quality processes, tools and methods strongly preferred.

• Experience with Rational tools, Six Sigma or other process improvement training strongly preferred.

• Experience with PEGA or Salesforce platform strongly preferred

• Experience with health care industry strongly preferred

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed 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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70888

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Social Work Case Manager

Work schedule: Monday - Friday 8:00 am - 5:00 pm EST with occasional evening hours

Location: Remote - GA, VA or NY

How you will make an impact

The Social Work Case Manager is responsible for performing social work case management services by making integrative psychosocial assessments, developing, implementing, coordinating, monitoring, and evaluating social work goals designed to optimize members access to social services across the care continuum and ensuring member access to services appropriate to their psychosocial needs.

Primary duties may include, but are not limited to:

• Conducts psychosocial assessments to identify individual needs and a specific social services/psychiatric needs to address objectives and goals as identified during assessment. Implements social work goals by advocating for members' needs.

• Networks with other community resources.

• Provides referrals within benefits structure.

• Develops and implements a metric system that tracks baseline levels of functioning throughout course of social work services by constructing necessary instruments that focus on identified psychosocial needs.

• Coordinates specific psychosocial resources to meet members identified needs.

• Monitors and evaluates effectiveness of the social work goals. Interfaces with Registered Nurse Care Managers and Management on the development, implementation, and progress of social work goals, and the member's responsiveness to resources rendered.

• Evaluates members' ability to independently manage self and locate alternative resources when limitations are identified.

• Provides guidance to members seeking alternative solutions to specific social, cultural or financial problems that impact their ability to manage their healthcare needs.

• Evaluates members' strengths related to health self-management, develops strategies to support healthcare needs and implements plans in support of case decisions.

• Facilitates and coordinates behavioral health resources as individual member needs are identified.

• Participates in social work case audit activities and assists supervisor with management of day-to-day activities, such as monitoring and prioritizing social work task-list workflow.

• Serves as first line contact for conflict resolution.

• Develops a medical social work module of training for staff social workers.

• Develops training materials, completes quality audits, performs process evaluations, and tests and monitors systems/process enhancements.

• Serves as a team lead, manages the most complex cases, assists in policy and procedure development, and leads projects with cross-functional teams or serves as a representative on enterprise initiatives.

Qualifications

Minimum Requirements:

• Requires an MS (at a minimum) in Social Work; 3 years of experience in case management in a health care environment; or any combination of education and experience, which would provide an equivalent background.

• Current unrestricted LMSW or LCSW license in applicable state(s) required.

  Preferred Capabilities, Skills and Experiences:

• Bilingual (Spanish) or multi-language skills preferred.

• Previous discharge planning experience a plus

  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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

  REQNUMBER: PS71832-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Overview

Retail Assembly Tech - Part Time

IMMEDIATE HIRING! $20+/HR INCLUDING BASE PAY AND PRODUCTIVITY INCENTIVE

*Summary of Position:*

Our Assembly Techs are experts at building items safely, quickly, and with attention to detail. It's not only the quality of the assembled product that set our technicians apart from the crowd, but also the pride they take by being part of a team of skilled trade professionals at T-ROC. If you are reliable, customer focused, and mechanically inclined who thrives by working at a fast pace, while maintaining attention to detail? If the answer is yes, then T-ROC is the place for you to start -building- your career!

Here are the details:

• Assembly of bicycles are most of your work, but you'll also be building outdoor grills, furniture, and other products for the end-customer or for store display.

• Efficiently and quickly set up work area to allow for effective product prep, fast builds, and movement of assembled inventory to sales floor or store storage area.

• Exhibit the highest level of competency, safety, and accuracy in the assembly of products.

• Work with store management to confirm what needs assembled and accurately enter required information into T-ROC's mobile reporting tool for proper tracking.

• Maintain equipment to keep all materials in working order in accordance with T-ROC's Assembly Technician Tools / Equipment Policy.

• Meet or exceed T-ROC's minimum performance standards as well as adhere to all retailer guidelines

• Maintain compliance with all required technician training.

• Participate in all required conference calls and team meetings.

What's in it for you?

• Competitive hourly pay, plus productivity incentive pay

• Medical, Dental and Vision Insurance, PTO, Daily Pay and more for full-time employees

• Paid Training and ongoing learning opportunities provided

• Great growth potential

Here's what you need to ROC this role:

• Conduct yourself in a neat, clean appearance and always be courteous and professional when interacting with store management and associates

• Maintain motivation, drive, and commitment that allows self-determination of increased income, based on daily work productivity.

• Being mechanically inclined and have used a variety power and manual tools assembling bicycles, gas grill, etc is a plus.

• Following written and diagramed directions for assembly of products

• Be a self-starter who can manage daily store assignments and solve problems in the assembly process with limited supervision.

• Establish confidence and a positive rapport with store management and associates.

• Have reliable transportation that provides the ability to transport self, tools, and equipment necessary to complete daily assembly assignments to your store location.

• Weekdays 8am-4pm. Some weekends and holiday availability.

• Can work steadily, with speed and accuracy for extended periods of time while working on tasks that require standing, kneeling, bending, lifting, twisting, etc must be met by employee to successfully perform this job

• Must be able to lift and/or move up to 60 pounds

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Who is T-ROC? A t T-ROC, we empower people with -Power of People and Technology -. You will have in the palm of your hand, the hottest brands rocking the most innovate technologies on the planet! Your knowledge will be the fuel that brings technology to life for your T-ROC customers!

What it is like to be a T-ROC'ER , your entrepreneurial spirit will be valued. Your desire to work honestly and with the utmost level of integrity will be appreciated while amazing customers with your technical expertise. Do you crave change ? We do so with gusto and have fun the T-ROC way!

If you don't yet follow us on social media, please do!

(https://www.youtube.com/channel/UCCoJTSZghmbr3XX8LcVVZHw) (http://www.facebook.com/TROCGlobal) (http://www.twitter.com/TROCGlobal)

Responsibilities

Equal Opportunity Employer / Special Accommodations

T-ROC is committed to the full inclusion of all qualified individuals. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex disability, age, sexual orientation, gender identity, national origin, veteran status or genetic information. As part of this commitment T-ROC will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed, please email ADA@trocglobal.com describing the accommodation.

Notice of E-Verify Participation

T-ROC participates in E-Verify. To learn more use this linkE-Verify (https://theretailoutsource.icims.com/icims2/servlet/icims2?module=AppInert&action=download&id=605462&hashed=760013352)

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Posted Date 7 hours ago (4/15/2022 3:14 PM)

Job ID 2022-107935

Classification Non-Exempt

Employee Type Full Time

Advertised Category Retail Assembly

# of Openings 1

ADP Job Location : Country US

ADP Job Location : State/Province VA

ADP Job Location : City VIRGINIA BEACH

ADP Job Location : Postal Code 23452

ADP Job Location : Address 657 PHOENIX DR

Job Detail

• Company:
  T-ROC

Job Description

Overview

Retail Assembly Tech - Part Time

IMMEDIATE HIRING! $20+/HR INCLUDING BASE PAY AND PRODUCTIVITY INCENTIVE

*Summary of Position:*

Our Assembly Techs are experts at building items safely, quickly, and with attention to detail. It's not only the quality of the assembled product that set our technicians apart from the crowd, but also the pride they take by being part of a team of skilled trade professionals at T-ROC. If you are reliable, customer focused, and mechanically inclined who thrives by working at a fast pace, while maintaining attention to detail? If the answer is yes, then T-ROC is the place for you to start -building- your career!

Here are the details:

• Assembly of bicycles are most of your work, but you'll also be building outdoor grills, furniture, and other products for the end-customer or for store display.

• Efficiently and quickly set up work area to allow for effective product prep, fast builds, and movement of assembled inventory to sales floor or store storage area.

• Exhibit the highest level of competency, safety, and accuracy in the assembly of products.

• Work with store management to confirm what needs assembled and accurately enter required information into T-ROC's mobile reporting tool for proper tracking.

• Maintain equipment to keep all materials in working order in accordance with T-ROC's Assembly Technician Tools / Equipment Policy.

• Meet or exceed T-ROC's minimum performance standards as well as adhere to all retailer guidelines

• Maintain compliance with all required technician training.

• Participate in all required conference calls and team meetings.

What's in it for you?

• Competitive hourly pay, plus productivity incentive pay

• Medical, Dental and Vision Insurance, PTO, Daily Pay and more for full-time employees

• Paid Training and ongoing learning opportunities provided

• Great growth potential

Here's what you need to ROC this role:

• Conduct yourself in a neat, clean appearance and always be courteous and professional when interacting with store management and associates.

• Maintain motivation, drive, and commitment that allows self-determination of increased income, based on daily work productivity.

• Being mechanically inclined and have used a variety power and manual tools assembling bicycles, gas grill, etc is a plus.

• Following written and diagramed directions for assembly of products

• Be a self-starter who can manage daily store assignments and solve problems in the assembly process with limited supervision.

• Establish confidence and a positive rapport with store management and associates.

• Have reliable transportation that provides the ability to transport self, tools, and equipment necessary to complete daily assembly assignments to your store location.

• Be willing to adhere to -retail hours- with flexibility and willingness to workday shifts, evening shifts, weekends and holidays

• Can work steadily, with speed and accuracy for extended periods of time while working on tasks that require standing, kneeling, bending, lifting, twisting, etc must be met by employee to successfully perform this job

• Must be able to lift and/or move up to 60 pounds

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Who is T-ROC? A t T-ROC, we empower people with -Power of People and Technology -. You will have in the palm of your hand, the hottest brands rocking the most innovate technologies on the planet! Your knowledge will be the fuel that brings technology to life for your T-ROC customers!

What it is like to be a T-ROC'ER , your entrepreneurial spirit will be valued. Your desire to work honestly and with the utmost level of integrity will be appreciated while amazing customers with your technical expertise. Do you crave change ? We do so with gusto and have fun the T-ROC way!

If you don't yet follow us on social media, please do!

(https://www.youtube.com/channel/UCCoJTSZghmbr3XX8LcVVZHw) (http://www.facebook.com/TROCGlobal) (http://www.twitter.com/TROCGlobal)

Responsibilities

Equal Opportunity Employer / Special Accommodations

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Posted Date 7 hours ago (4/15/2022 3:03 PM)

Job ID 2022-107933

Classification Non-Exempt

Employee Type Part Time

Advertised Category Retail Assembly

# of Openings 1

ADP Job Location : Country US

ADP Job Location : State/Province VA

ADP Job Location : City VIRGINIA BEACH

ADP Job Location : Postal Code 23456

ADP Job Location : Address 2021 LYNNHAVEN PKWY

Job Detail

• Company:
  T-ROC

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Job Title: Senior Business Information Consultant (Population Health)

Be part of an extraordinary team. We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for coordinating and consolidating various impact analyses for management reporting.

Primary duties may include, but are not limited to:

• Establishes, improves, and optimizes the consolidating processes for forecast and month-end results. Consolidates and prepares executive summary reports for various business segments in the SBU for top management decision-making.

• Analyzes and designs solutions to address varied and highly complex business needs.

• May collaborate with businesses and technical areas to implement new or enhanced products.

• May require strong knowledge of products as well as our internal business models and data systems.

• May coordinate with external audits as appropriate.

• Acts as the central contact with internal departments and external auditors.

Qualifications

• Requires a BS/BA degree in Statistics, Economics, or Business Administration

• Minimum of 12 years of relevant experience;

• Or any combination of education and experience which would provide an equivalent background.

• Experience providing leadership in evaluating financial performance of complex organizations strongly preferred. Excellent leadership, problem solving, organizational, planning, presentation and interpersonal skills strongly preferred.

• Ability to work independently and draw up plans to address issues/concerns strongly preferred.

• Experience with Visualization tools such as Tableau or Power BI required.

• Experience with Python, SQL, and/or R required

• AWS Cloud Computing experience highly desired.

• SAS, Azure, Apache experience a plus.

• Experience in implementation and/or support of Population Health systems/solutions, such as but not limited to: Risk Stratification Registries, Case Management Systems, Claims Adjudication Systems, IVR technology, Prior Authorization, etc. preferred.

• General knowledge and understanding of value based care and accountable care concepts, and of different healthcare plans (Medicare, Medicaid and Commercial Plans) preferred.

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS71256-Virginia

Job Detail

• Company:
  Anthem, Inc.