Company Detail

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 Financial Operations Recovery Specialist II is responsible for discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to cash receipts, cash application, claim audits collections, overpayment vendor validation, and claim adjustments

Primary duties may include, but are not limited to:

• Handling high volume calls with providers

• Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting, or other research.

• Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies. Works closely with staff from other departments on a regular basis to ensure customer satisfaction.

• Works closely with contract managers to identify and correct contractual issues when applicable.

• May perform collection activities to ensure the recovery of overpayments and maintenance of unprocessed cash and accounts receivable processes and all other cash applications as required.

• Researches voluntary refunds for accuracy.

• Requires accurate balancing of all accounts.

Qualifications

Primary requirements:

• Requires a H.S. diploma

• Minimum of 2 years of claims processing and/or customer service experience

• Any combination of education and experience, which would provide an equivalent background.

Preferred requirements:

• AA/AS or higher level degree 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: PS72354

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

EAP Account Manager II Work location: One of the following Anthem states - California, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, Wisconsin; may consider other locations for the most qualified applicant.

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 managing an assigned book of EAP business (Groups 1,000-5,000) that includes large complex Local, ANA, BHR, and International customers and providing planning and strategy for the execution of marketing/sales activities in assigned geographic area and market segment. Primary duties may include, but are not limited to: Engages in supportive sales activities including RFI response, RFP response, research, prospecting, account-based networking, professional association participation, trade shows and other opportunities. Provides account management services for assigned accounts including, but not limited to: management consultations, employee orientations, supervisory training, critical incident stress debriefing response, and renewal functions. Provides consultation to employers related to chemical dependency, mental health, and other human behavioral concerns. Consults with employers on policy development; prepares and analyzes utilization reporting data. Negotiates and implements internal and external account implementation protocols and provides pricing information for new and existing accounts. Executes retention and new sales strategies developed by management.

Qualifications

Requires an MS in mental health care field a minimum of 5 years of experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills and Experience Experience working in the managed care/healthcare insurance industry is 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: PS65084-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?

Location: This is a Work-at-Home Opportunity. It is highly preferred that the selected candidate resides in the Eastern United States.

Currently, we're reimagining our marketing organization - we're focusing our energies on bringing Anthem's brand promise to life across all aspects of the consumer experience. We are eliminating traditional marketing silos, so all Anthem talent is working together to improve the health and wellness of our members. If you have a passion for a career that impacts individual lives, we'd like to speak with you about joining our marketing team.

The Marketing Communications Writer Sr. is responsible for providing advanced creative, technical advice, and writing support for the development and implementation of highly complex marketing communication materials. Primary duties include, but are not limited to:

• Consult with business leaders to identify business objectives.

• Evaluates the effectiveness of communication plans and materials and recommend new communication strategies and implementation approaches.

• Collaborates with creative teams on client needs and develops and implements communication solutions.

• Researches, writes, edits, and reviews content for traditionally printed programs (marketing collateral, trade publication advertising, direct mail, etc.) and/or digital programs (emails, websites, microsites, text campaigns, etc.).

• Ensures all materials meet internal and external business and legal standards and follows appropriate corporate standards, guidelines, and approval processes.

• Identifies improvements/efficiencies that support operational excellence, and supports business initiatives (plain language, standardization, going paperless, etc.).

Qualifications

Minimum Requirements: Requires a BA/BS degree; 5 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualification, Skills & Experiences: Experience in healthcare or managed care preferred. Excellent interpersonal, verbal, and written skills. Ability to pivot quickly and work in a fast-paced environment. Background in creative strategy, conception, and implementation. Experience understanding and writing in a brand voice for multiple audiences. Strong copyediting and proofreading skills. Experience in Workfront is 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: PS72147-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?

This position can be filled at the Care Consultant or Care Consultant Sr level. The hiring manager will determine the level, based on the candidate's experience and background.

Care Consultant

Primary duties may include, but are not limited to:

• Responsible for providing support to providers to improve the effectiveness and efficiencies of provider practices.

• Obtains and analyzes quality metrics and reports for care opportunities, supports practice implementation of care coordination and care management, identifies action plans for providers to implement to improve cost, quality and the patient experience and participates in design, development, and implementation of community learning forums.

• Collaborates with Patient Centered Primary Care team including but not limited to: engagement manager, clinical liaison, provider contractors and network relations reps to meet provider and practice service needs.

• Actively participates in developing program recommendations and action plans (Internal).

• Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients.

• Promotes practice transformation to team based patient centered care delivery.

• Provides education for practices to develop expertise with metrics and data review for quality improvement.

• May participate in various community and multi-department committees to assure effective program implementation.

• Tracks progress of program and prepares status reports to management or senior management.

• Maintains up to date knowledge on Patient Centered medical Home, Care Delivery System Redesign and Accountable Care Organizations.

Care Consultant Sr

Primary duties may include, but are not limited to:

• Obtains and analyzes practice specific cost and quality data and reports for cost of care and quality opportunities.

• Helps practice to target high risk Anthem members and gaps in care based on reports provided.

• Supports practice implementation of population health management, care coordination and care management strategies.

• Identifies action plans for providers to implement to improve cost, quality and the patient experience and participates in design, development, and implementation of community learning forums.

• Serves as the point of contact for providers and primary care practices for program on boarding.

• Facilitator of routine meetings between Anthem and the provider office.

• Serves as the subject matter expert and liaison with Anthem Care Management to facilitate clinical processes between the company and the provider office.

• Creates and hosts tailored learning opportunities to support the deployment of program interventions.

• Hosts collaborative learning events that allow practices to learn from one another and national experts, use of the Provider Care Management Solutions (PCMS) tool and other data sources, and provides technical support for the Care Delivery Transformation program within the Enhanced Personal Health Care program (EPHC).

• Collaborates with EPHC team and other program stakeholders, including but not limited to: CDT Market lead, EPHC Provider Solutions team to meet provider and practice service needs.

Qualifications

Care Consultant

Minimum Requirements

• Requires a BA/BS and a minimum of 3 years health care experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Requirements

• Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, and electronic health records strongly preferred.

Care Consultant Sr

Minimum Requirements

• Requires a BA/BS and minimum of 5 years health care experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Requirements

• Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, population health and care management structures, data analytics and electronic health records preferred.

• Clinical background and/or MBA not required but 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: PS71920-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Part-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. Join our Ohio team as our next part time Medical Director!

Part Time: 20 hours a week

Location: This position will allow work from your home as long as candidates are willing to travel to our Columbus, OH office for meetings as needed.

The Behavioral Health Medical Director for Ohio Medicaid is responsible for the administration of behavioral health services for company health plans including the overall medical policies of the business unit to ensure the appropriate and most cost-effective medical care is received and for the day-to-day management of medical management staff.

Primary duties may include but are not limited to:

• Interprets existing policies and develops new policies based on changes in the healthcare or medical arena.

• Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality, cost-effectiveness, and outcomes.

• Identifies and develops opportunities for innovation to increase effectiveness and quality.

• Serves as a resource and consultant to other areas of the company, may chair or serve on company committees, may be required to represent the company to external entities and/or serve on external committees, conduct peer clinical and/ or appeal case reviews and peer to peer clinical reviews with attending physicians or other ordering providers to discuss review determinations, provides guidance for clinical operational aspects of the program.

• Supports the medical management staff ensuring timely and consistent responses to members and providers.

Qualifications

• M.D. or D.O. required.

• Active unrestricted medical license to practice medicine or a health profession in Ohio required.

• Residency in Ohio required.

• Board Certified by the American Board of Psychiatry and Neurology in Psychiatry required.

• At least 5 years of post-residency clinical experience required.

• Experience with child/adolescent population a plus.

• Addiction Psychiatry background preferred.

• Experience with Ohio Medicaid highly preferred.

• Ability to attend meetings as needed at our Columbus, OH required.

• Ability to work collaboratively with a multi-disciplinary team required.

• Utilization Management and managed care 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: PS72234-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Job Title: Financial Accountant SR Location: Wisconsin | Kentucky | Ohio | Indiana | must reside in posted state

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. Meridian is a proud member of Anthem's family of brands. We are a health care cost containment company offering subrogation recovery services. The Financial Accountant SR is responsible for supporting the closing, reconciling, analysis and reporting of the general ledger.

How you will make an impact: - Completes highly complex account reconciliation. - Prepares internal and external monthly, quarterly and annual financial reporting and analysis. - Verifies the integrity of monthly results by completing various analyses and interpreting the data.

Qualifications

Minimum Requirements: - Requires a BA/BS in Accounting and a minimum of 4 years previous accounting experience

Preferred Skills, Capabilities and Experiences: - CPA, CMA, or MBA preferred. - Previous work experience with month end close processes, account reconciliation and statutory accounting principles preferred. - Experience with Peoplesoft/Oracle preferred. - Health insurance accounting preferred. - Extensive Microsoft Excel skills preferred. - General ledger accounting packages 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: PS68977-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

$500 Sign on Bonus

Medical Records Clerk Miami, FL

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 Medical Records Clerk is responsible for maintaining patient files, responds to requests for medical records and performs clerical activities in support of the medical records department.

Primary duties may include, but are not limited to:

• Protect the security and integrity of medical records to ensure that patient confidentiality is maintained in compliance with company policies and federal, state and local regulations.

• Maintains patient files and retrieves files for scheduled appointments.

• Responds to requests for medical records; processes letters and report.

Qualifications

Minimum Qualifications:

• Requires a high school diploma or GED and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.

• Must be willing to work in our clinic location of 7900 NW. 27th Avenue, Miami.

Preferred Qualifications:

• Bilingual in English/ Spanish 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: PS71825-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Title: Business Change Manager SR (Test Program Manager) Location: Candidate must be within 50 miles of Anthem Pulse Point location - operating in Eastern Time Zone

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. A proud member of the Anthem, Inc. family of companies, IngenioRx leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The Business Change Manager SR is responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals.

How you will make an impact: - Manages the relationship with project/program stakeholders (IT and business). - Develops test strategy, leads and coordinates all testing within a project/program. - Plays a leadership role in the design, development, and implementation of testing components. - Defines appropriate testing methods to employ to assure developed product conforms to requirements and design. - Reviews/Approves all project related test assets for completeness and quality. - Collects testing metrics, reports status as defined in test plan with supporting data. - Manages both onshore and offshore test execution resources for project under test. - Accountable for Test Data Management, collection of requirements, evaluation of available data in repositories, identify gaps, align Configuration Management and Release Management on data needs and own test data provisioning tasks - Develops testing project plan and ensures testing activities planned stay on track and under budget. - May provide direction and guidance to team members and serves as an expert for the team.

Qualifications

Minimum Requirements: - Requires a BA/BS in a related field and minimum of 8 years process improvement, business change or project related experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: - Experience in successfully developing and managing projects with fairly significant operating budget and knowledge of process redesign strongly preferred. - 5 years of experience with at least one of the following test management tools: HP ALM, JIRA and QTEST preferred - 3 years of experience with Agile methodologies preferred - 1 year of experience in test data management preferred - Experience with pharmacy prescription drug claims testing, benefits and clinical testing is a plus - Experience with test automation tools is a plus - Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills - Ability to work in a dynamic environment

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: PS71839

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 developing and implementing clinical pharmacy programs to promote quality and cost-effective drug utilization.

How you will make an impact:

• Manages associates developing and configuring prior authorization decision trees in the Prior Authorization workflow tool

• Manages associates' quality assurance of prior authorization decision trees within the Prior Authorization workflow tool

• Provides clinical consulting services to internal partners.

• Assists in implementing clinical programs within the prior authorization space

• Ensures achievement of department goals and objectives.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

Requirements:

• Requires at least a BA/BS in Pharmacy or a PharmD

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

• Must possess an active unrestricted state license or certification to practice pharmacy within the scope of practice in a state or territory of the United States (Rph).

Preferred Skills, Capabilities and Experiences:

• PharmD preferred.

• Prior Authorization experience strongly preferred.

• Previous Management 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: PS71785

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?

Location: Remote

Design modeling studies to address specific business issues determined by consultation with business partners. Employs advanced analytics to gain critical insights into member behavior drivers and preferences, product/program concepts and value propositions, operational effectiveness and efficiencies, client specific health gaps and needs. Consults business leaders and internal partners to apply the insights to test and drive product innovation and enhancement, to target the right members for the right service, to measure program outcome and demonstrate value, to help win and retain clients, and to support information based strategic decision making.

Primary duties may include, but are not limited to:

• Consults on considerations related to designing and executing tests or pilot programs

• Contributes to the design of new program/initiative based on test/pilot outcomes

• Develops targeting criteria or customer segmentation based on analytical insights, clinical inputs, product design and operations considerations

• Develops predictive models and other tools that help target the right members

• Develops methodology to measure clinical, utilization and financial outcomes of a program/initiative

• Conducts in-depth research to address challenging issues in measuring outcomes

• Prepares analytical data sets in support of modeling studies.

• Proactively collaborates with business partners to determine identified population segments and develop actionable plans to enable the identification of patterns related to quality, use, cost and other variables.

Qualifications

Minimum Requirements

• Requires MS, MA, or PhD with concentration in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research, a minimum of 3 years direct experience programming large, multi-source datasets with SAS required, and a minimum of 3 years in health care setting; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• Advanced expertise with SAS, R, or equivalent analytical tool.

• Comprehensive experience with Teradata, SQL, or equivalent data base tools.

• Proven ability to design modeling studies and experience with data models, addressing data quality issues in study design, constructing robust and efficient analytical data sets strongly preferred.

• Experience in healthcare related field 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: PS70620

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Job Title: Marketing Communication Coordinator II (Medicaid) Location: Hybrid/Mainly remote - must be able to commute to nearest Anthem/Pulse Point VA office. Only considering candidates in the state of Virginia.

Hours: Standard, Monday-Friday 8-5p/9-6p EST

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?

How you will make an impact:

• The Marketing Communications Coordinator II is responsible for facilitating all steps of moderately complex marketing communication (Marcom) project workflows.

  Primary duties may include, but are not limited to:

• Works with Marketing Communications areas to facilitate projects through all stages (research, design, writing, proofreading, review, printing, mailing and archival) to ensure the product is produced in a timely, accurate, and effective manner.

• Acts as primary client interface and collaborates with business partners and SMEs on projects.

• Reviews requests and recommends communication solutions.

• Schedules and leads project meetings with business partners.

• Acts as project manager for workflow process and is responsible for ensuring consistency and standardization on all materials.

• Coordinates project reviews and re-negotiates terms/deadlines as appropriate.

• Creates production schedules, assigns form numbers, requests source files and manages the production process of materials.

• Seeks out opportunities for process improvements/efficiencies, and supports business initiatives (standardization, going paperless, etc.).

Qualifications

Minimum Requirements:

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

  Preferred Skills, Capabilities and Experiences:

• Prior health care industry experience and project/process management skills preferred.

• Experience with Workfront is highly desirable.

  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: PS71453-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Customer Care Representative I, II, III Remote: Within 50 miles 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?

Build the Possibilities. Make an extraordinary impact. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Beacon Health Options is a proud member of the Anthem Inc family of companies. As a Customer Care Representative, you will be responsible for successfully completing the required basic training. As a Customer Care Representative, you will be able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. You must pass the appropriate pre-employment test battery.

How you will make an impact:

• Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.

• Analyzes problems and provides information/solutions.

• Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.

• Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

• Researches and analyzes data to address operational challenges and customer service issues. Provides external and internal customers with requested information.

• Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature. Uses computerized systems for tracking, information gathering and troubleshooting.

• Outbound calls are conducted in the ZipDrug business area.

Qualifications

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

Minimum Requirements:

• CCRI - Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.

• CCRII - Requires a HS diploma or equivalent and a minimum of 1 year of the company's experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background

• CCRIII - Requires a HS diploma or equivalent and a minimum of 3 years of the company's experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.

• Ability to work from home with internet access and a quiet and private work space

Preferred Skills, Capabilities and Experience:

• A passion for serving others with the ability to be empathetic and the desire to go above and beyond to help resolve members questions at the first point of contact

• A customer advocate willing to listen and find creative solutions to address and resolve customers questions, issues or concerns

• A composed individual able to multi-task, navigating multiple computer applications and working efficiently while communicating and serving the customer

• Must have a strong work ethic and sense of responsibility to your team mates and our members, demonstrated by the simplest things like being on time and available to meet member's needs, to being accountable for commitments made to customers or others and ensuring follow-ups are completed.

• Flexible and quick learner, willing to adapt to changing customer and business needs.

• 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.

• Medical background.

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: PS72073-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

$1,000 Sign on Bonus

X-ray Technician Miami, FL

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 X-ray Technician is responsible for assisting in examinations and treatment of patients under the direction of the physician.

Primary duties may include, but are not limited to:

• Takes, develops, and charts all x-rays.

• Maintains daily x-ray log and filing system.

• Sends/transports original films to Radiology for reading.

• Maintains x-ray logs.

• Calls for phone reports.

• Cleans cassettes.

• Schedules maintenance and oversees equipment cleaning.

• Maintains office and supply inventory.

Qualifications

Minimum Requirements:

• Requires high school diploma or equivalent and minimum of 1 year of experience as an X-ray Technician; or any combination of education and experience, which would provide an equivalent background.

• Current limited license in X-ray Technology for applicable state required.

• Bi-lingual (English/Spanish) required in most offices.

• For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position.

• Must be willing to work in our clinic location of 7900 NW. 27th Avenue, Miami.

  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: PS71824-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.

Wellness & Recovery Specialist

Responsible for care coordination and/or care management activities focused on the Wellness and Recovery of Amerigroup members.

Primary duties may include, but are not limited to:

• Identifies opportunities for engagement of members and their families in forming a supportive, recovery network.

• Develops and implements provision of onsite psychiatric discharge planning education at Recovery and Resiliency sites.

• Collaborates with Stabilization Teams as a member advocate in discharge planning education, resolution of barriers, and service transitions.

• Acts as a resource for staff on decision making and problem solving.

• Initiates and maintains contact with assigned individuals and providers to determine members response to services.

Qualifications

Requirements:

• Requires AA/AS and minimum of 2 years of experience in health services or behavioral health field or in a peer support services role; or any combination of education and experience, which would provide an equivalent background.

• Peer Specialist Certification required.

Preferred:

Knowledge of care-coordination and case management concepts strongly preferred. BA/BS or MBA 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: 0165630-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Job Title: Senior Engineer

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 delivery of end to end application, system development and maintenance on complex multi technology platforms within assigned client group, business unit or corporate department and utilizing various customer technology platforms.

Primary duties may include, but are not limited to:

• Maintains active relationships with customers to determine business requirements and leads requirements gathering meetings.

• Owns the change request process and may coordinate with other teams as necessary.

• Provides technical advice and weighs in on technical decisions that impact cross functional teams.

• Researches and may propose new technologies.

• Develops and owns list of final enhancements. Develops and defines application scope and objectives and prepares technical and/or functional specifications from with programs will be written.

• Performs technical design reviews and code reviews. May own technical testing to ensures unit test is completed and meets the test plan requirements, system testing is completed and system is implemented according to plan. Assesses current status and supports data information planning. Coordinates on-call support and ensures effective monitoring of system.

• Maintains technical development environment.

• Mentors others and may lead multiple or small to medium sized projects.

• Will begin to set direction at the project/service level and influences decision-making.

• Provides technical guidance, and mentoring.

• Understands the tradeoffs between technical, analytical and product needs of the technical solutions.

• Identifies and propose strategies around technical problems affecting team, communicates standards and gets buy-in on solutions.

• Facilitates group sessions to elicit complex information on requirements clarification, design sessions, code reviews and troubleshooting issues.

• Supports vendor evaluation.

Qualifications

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

• Minimum of 5 years related experience; multi dimensional platform experience; expert level experience with business and technical applications;

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

• Multi database and/or multi language strongly preferred.

• Experience mentoring others, leading multiple small projects and providing troubleshooting support is 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: PS72133-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Title: Business Change Manager (IT Quality Control Advisor) Location: Candidate must be within 50 miles of Anthem Pulse Point location - operating in Eastern Time Zone

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. A proud member of the Anthem, Inc. family of companies, IngenioRx leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The Business Change Manager is responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals.

How you will make an impact: - Manages the relationship with project/program stakeholders (IT and business). - Supports test manager with development of test strategy, supports testing and test coordination within a project/program. - Supports test manager with defining appropriate testing methods to employ to assure developed product conforms to requirements and design. - Performs test case design and test execution. - Collects testing metrics, reports status as defined in test plan with supporting data. - Coordinates with other onshore and offshore test execution resources for project under test. - Identifies test data needs, performs evaluation of available data in repositories, identify gaps, coordinates with Test Data management team and own test data provisioning tasks. - Develops test plan and ensures testing activities planned stay on track. - Conducts test scenario and test result reviews with project stakeholders. - May provide direction and guidance to team members and serves as an expert for the team.

Qualifications

Minimum Requirements: - Requires a BA/BS in a related field and minimum of 5 years process or project related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences: - Experience in successfully developing and managing projects with fairly significant operating budget and knowledge of process redesign is strongly preferred. - Prior experience handling end to end testing of programs involving digital Cloud based web applications is preferred. - Pharmacy background is preferred - Experience with pharmacy prescription drug claims testing, benefits and clinical testing is preferred - Experience with at least one of the following test management tools: HP ALM, JIRA and QTEST - Experience with SQL is preferred - Experience with Agile methodologies is preferred - Experience in test data management is 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: PS71838

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Title: Marketing Manager Location: Ohio

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 product marketing lead is responsible for bringing new products and capabilities to market, ensuring that the sales team, customers and prospective customers understand it, and driving demand and usage of assigned products.

How you will make an impact: - Develop in-depth knowledge of assigned product(s), audiences, and personas - Understand market and client needs - Analyze competitive offerings - Determine value story and key differentiators

Product content: - Create and own key product messaging assets including product overview documentation, and standard feature grids - Create own ongoing management/updates to core sales assets including standard decks, sales slicks, and product brochures - Coordinate input and approvals from key stakeholders to support go-to-market and sales efficiency

Product marketing strategies: - Lead key strategies, such as branding, naming, targeting, and segmentation models - Consider distribution, penetration, market share, product mix, media mix, and competition in defining and developing metrics-based and insights-driven marketing strategies - Consult with product and sales partners to develop/lead ongoing campaign strategies that drive growth - Drive thought leadership for assigned product(s) - Build product marketing budget

Qualifications

Minimum Requirements: - Requires a BA/BS degree and a minimum of 5 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences: - Managed care experience preferred. - Experience working with executive level staff preferred - Broad and deep understanding of strategic planning and project management preferred - Managed care product 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: PS70531-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Nurse Medical Management I/II Location: W@H

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 to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical issues.

• 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 precertification, 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.

• Consults 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

QUALIFICATIONS: MINIMUM REQUIREMENTS: Nurse Medical Mgmt I Requires current active unrestricted RN license to practice as a health professional in applicable state(s) or territory of the United States. Requires minimum of 2 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. PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: 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.

Nurse Medical Mgmt II Requires current active unrestricted RN license to practice as a health professional in applicable state(s) or territory of the United States. Requires minimum of 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. PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: 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.

Position may be filled at a NMM I/II dependent on experience and background.

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: PS71349

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Title: Proposal Develop Analyst SR Location: MA|IA|NY|VA|GA|KY| IN|OH|MO|CA; Candidate does not have to reside in state; No time zone preference

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. (optional) The Proposal Develop Analyst SR is responsible for completing RFPs, including providing technical and consultative support relative to the execution of sales strategies and proposal development for large commercial (private and public) pre-sale accounts. How you will make an impact: - Develops and delivers large account proposals, including responding to broker/consultant specifications and questionnaires, interpreting questionnaires, researching answers and crafting responses with the assistance of a Q&A database. - Manages the coordination of proposal activities and responses with other operating areas such as Claims, Underwriting, Sales, and Specialty companies assuring their actions come together as a seamless response to the Request For Proposal (RFP). - Responds to detailed RFP specifications requests in a manner which expounds upon the business units' capabilities with respect to product design, managed care programs, financial strategies, etc. - Coordinates and participates in Strategy Meeting conference calls with Sales and Underwriting. - Assists with the integration of new products and services within the proposal database, including updating, rewriting and editing the various databases used in creating proposals.

Qualifications

Minimum Requirements: Proposal Develop Analyst SR - Requires a BA/BS degree and a minimum of 3 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences: - Excellent project management, problem-solving and analytical skills. - Highly developed skills in writing, editing, and proofreading with the ability to draft clear, persuasive copy. - Ability to execute multiple, ongoing projects in a timely and accurate manner in a high-pressure, deadline-driven environment. - Excellent verbal and interpersonal communication skills. - Strong working knowledge of the Microsoft Office suite of products. - Health care industry knowledge Familiarity with commercial business and/or group sales support experience. - RFPexperience. - Proven win rate with large complex bid responses.

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: PS71524-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Job Title: Network Relations Consult Location: Remote (Must be based in Virginia)

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?

How you will make an impact:

• Develops and maintains positive provider relationships with provider community by regular on-site visits, communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues.

• Serving as a knowledge and resource expert regarding provider issues impacting provider satisfaction, researches and resolves complex provider issues and appeals for prompt resolution.

• May be responsible for coordinating non-negotiated contracts for new and existing providers as needed.

• Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.

• May participation in Joint Operation Committees (JOC) of larger provider groups.

• Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.

• Conducts seminars to support the understanding of managed care policies and procedures. Identifies network access and deficiencies and develops recruitment and contracting strategies.

• Coordinates and conducts provider training including developing and distributing provider relations materials.

• Responsible for providing quality, accessible and comprehensive service to the company's provider community.

• Provide assistance regarding education, contract questions and non-routine claim issues.

• Coordinates communications process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.

• Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department.

• Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery.

• Tracks and conduct provider refresher training. Researches issues that may impact future provider negotiations or jeopardize network retention.

Qualifications

Minimum Requirements:

• Requires a Bachelor's degree and a minimum of 3 years of customer service experience including 2 years experience as a Network Management Rep; or any combination of education and experience, which would provide an equivalent background. Travel may be 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: PS71858-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, 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 Scheduled Monday - Friday 8 hour shifts 8:30am -5:00pm (EST), 9:30am -6:00pm (EST), 11:30am -8:00pm (EST)

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: PS70981-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Nurse Case Manager I/II Location: W@H Hours: 8:00-5:00 pm EST with 2-4 shifts/month of 11:30-8:00 pm EST

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 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.

• Assists with development of utilization/care management policies and procedures.

Qualifications

QUALIFICATIONS: MINIMUM REQUIREMENTS: NURSE CASE MANAGER I: 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. Multi-state licensure is required if this individual is providing services in multiple states.

PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: Certification as a Case Manager is preferred.

NURSE CASE MANAGER II: Requires BA/BS in a health related field and minimum of 5 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. Multi-state licensure is required if this individual is providing services in multiple states.

PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: Certification as a Case Manager is preferred.

Position can be filled at NCM I or NCM II dependent on manager discretion

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: PS71513-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Nurse Case Manager I/II/Sr Location: W@H Hours: M-F 8-4:30pm EST with 2-3 evenings a month 11:30-8p EST; Differential for evening shift if located in EST

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 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.

• 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.

• Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups.

• May require the development of a focused skill set including comprehensive knowledge of specific disease process or traumatic injury and functions as preceptor for new care management staff.

• Participates in department audit activities.

Qualifications

QUALIFICATIONS: MINIMUM REQUIREMENTS: Nurse Case Manager I 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. Multi-state licensure is required if this individual is providing services in multiple states. PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: Certification as a Case Manager is preferred.

MINIMUM REQUIREMENTS: Nurse Case Manager II Requires BA/BS in a health related field and minimum of 5 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. Multi-state licensure is required if this individual is providing services in multiple states. PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: Certification as a Case Manager is preferred. MINIMUM REQUIREMENTS: Nurse Case Manager Sr: Requires BA/BS in a health related field and minimum of 5 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. Multi-state licensure is required if this individual is providing services in multiple states. PREFERRED SKILLS, CAPABILITIES, AND EXPERIENCE: Certification as a Case Manager is preferred.

The position can be filled as a Nurse Case Manager I/II/ Sr, the level will be determined based on the candidates experience and background 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: PS71512-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Title: Health Promotion Consultant

Location: This position will telephonically outreach members throughout our East Region. The person needs to be located in either CT,GA,VA,ME, or NH within a reasonable distance from 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?

Responsible for ensuring contract compliance with state mandated cultural and linguistic, health education requirements, or other programs required by contracts.

Primary duties may include, but are not limited to:

• Assists with the State/Region/Local Needs Assessment document and identifies/develops resources to meet health education needs.

• Defines the marketing environment through development of key stakeholder criteria, identification of desirable community partners, availability of local programs and opportunities for marketing programs and services.

• Provides/promotes provider training to assure compliance with government mandated health education programs and the health education referral system.

• Establishes positive relationships with community based organizations and other key partners to gain understanding of the cultural and linguistic needs of members.

• Recommends health education programs based on analysis of State/Regional/Local health statistics, disease prevalence, census data, and health care service usage.

• Maps community based assets and collaborates with key stakeholders to leverage available resources for development of new and accessibility to existing health education/promotion programs.

• Develops and implements strategies that promote local health education resources and address identified member health education needs.

Qualifications

Requires a BS/BA degree and a minimum of 2 years experience; or any combination of education and experience which would provide an equivalent background.

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: PS70486-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?

Job Description: We're looking for a dynamic marketing project manager to help us deliver on our vision for the enrollee and member journey by developing and implementing marketing engagement solutions. This role will be responsible for execution of custom National Account member marketing strategies and plans. Supporting the end-to-end lifecycle of moderate complexity, often multi-channel, marketing campaigns by providing project management and/or executional support and may provide direction to a Project Coordinator. This position requires a high level of attention to detail, highly motivated and self-driven team player with the ability to successfully partner with multiple departments in order to meet deadlines established and execute flawlessly to achieve defined objectives.

This is a Remote Position Working Hours 8 AM - 5 PM (EST or CST)

Primary duties may include, but are not limited to: - Supports marketing strategies by ensuring projects are delivered on time, on scope and on budget. - Execute multiple projects simultaneously and ensure that they run smoothly and successfully - Works actively with marketing strategy partners and creative teams to facilitate successful delivery of Integrated Marketing Plans, tactical campaigns, and development of marketing assets - Provides strategic counsel and executes project management best practices and tactics that align with brand objectives/goals. - Supports the strategy and leads planning for assigned brands and phases across the entire consumer lifecycle. - Develops functional specifications and requirement documents. - Develops and manages project timelines. - Works with creative teams to facilitate projects through all stages to ensure deliverables are produced in a timely, accurate and effective manner, such as: research, writing, design, proofreading, translation, final review/approval, print, mail, POD programming, and posting/archiving assets - Engages and secures appropriate reviews for Legal, Compliance or other Control Partner - Flags concerns or roadblocks with Strategy/Planner to determine and activate next best steps - Collaborates with a large group of stakeholders across Marketing to ensure functional specifications and requirement documents are met.

Qualifications

Minimum Qualifications: - Requires a BA/BS degree and a minimum of 5 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications: - Master's degree a plus - Experience in insurance industry; group insurance experience a plus - Must have project management experience; PMP or other project management certification a plus - Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

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: PS71853-Virginia

Job Detail

• Company:
  Anthem, Inc.