Company Detail

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Grievance & Appeals Risk Analyst I or II

Executive Concierge Risk Analyst I or II

United States

Be a part of an extraordinary team

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

Build the Possibilities. Make an extraordinary impact.

Your Talent. Our Vision. At Anthem, Inc., it's powerful combination, and the foundation upon which we're creating greater access to care for our members., great value for our customers, and great 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.

The Grievance & Appeals Risk Analyst I is responsible for responding to inquiries received from regulatory agencies for one or more states or functions and/or for responding to inquiries/complaints received by executive leadership. Responsible for providing support to legal, management and executive level associates through a variety of assignments and projects which utilize knowledge specific to the company.

Primary duties may include, but are not limited to:

• Analyzes and evaluates inquiries, complaints, reports, and/or filings. Prepares and organizes case research, notes, and documents.

• Conducts research and analysis and recommends appropriate course of action and next steps for management review.

• Performs fact checking, gathers documents, researches and responds to inquiries and records requests and assists with investigative and discovery activities and processes.

• Corresponds with attorneys both internal and external in grievances and appeals regulatory cases.

  The Grievance & Appeals Risk Analyst II is responsible for providing support services for multiple states, enterprise-wide functions and/or complex issues through complex assignments and projects, which utilize recognized areas of specialization and knowledge specific to the company.

  Primary duties may include but are not limited to:

• Prepares, analyzes and evaluates written correspondence such as complaints, grievances, document demands, alleged ERISA violations and researches to resolve problems and close outstanding issues at the state or enterprise level.

• Conducts research and analysis, recommends appropriate course of action and next steps.

• Performs fact checking, gathers documents, researches and responds to records requests, and various inquiries from internal and external sources, coordinates investigative and discovery activities specific to Grievance and Appeal functions.

• Assists with compliance issues as needed.

• Attends and represents Grievances & Appeals at appropriate legal proceedings and arbitration hearings under supervision of counsel.

• Participates on projects and may participate in negotiations and strategizing with business and staff.

• Enters information as required into appropriate databases or other document management systems.

• May serve as a resource to other support staff.

Qualifications

Grievance & Appeals Risk Analyst I Minimum Requirements:

• Requires a HS diploma and a minimum of 2 years of Grievance & Appeals or related experience; or any combination of education and experience which would provide an equivalent background.

• Facilitation skills required.

  Grievance & Appeals Risk Analyst I Preferred Requirements:

• BA/BS in a related field preferred.

• Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills preferred.

• Proficient in Microsoft Office.

• Customer Service experience preferred

  Grievance & Appeals Risk Analyst II Minimum Requirements:

• Requires a HS diploma and a minimum of 5 years of Grievance & Appeals or related experience; or any combination of education and experience which would provide an equivalent background.

• Facilitation skills required.

  Grievance & Appeals Risk Analyst II Preferred Requirements:

• BA/BS in a related field a plus.

• Claims adjustment/processing experience preferred.

• Proficient in Microsoft Office.

• Customer Service 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: PS71129-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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

Position ideally located in Chicago, IL but will consider other locations specifically GA, IN, OH, VA, NY . Position will have the opportunity to work remotely, in office or a combination of both.

This position is posted as a job family - Business Analyst II, Business Analyst III

At AIM Specialty Health (AIM) , a proud member of the Anthem, Inc. family of companies, 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.

Do you enjoy analyzing data and figuring out what it's telling you? Are you good at turning your findings into a meaningful story? The Business Analytics and Insights team at AIM Specialty Health seeks seasoned healthcare analytics professionals to join our team. Merge your business acumen and passion for numbers to deliver critical business insights that will generate lasting results to new, existing, and future clients.

Primary duties may include, but are not limited to:

• Support the planning and development of operational, financial, and statistical analysis of cost of care program outcomes.

• Support analytics deliverables tied to team-oriented initiatives. Raise up project and organizational roadblocks to deliver analyses that facilitate business decisions.

• Independently mine medical claims, eligibility, and clinical operations data to track key performance metrics and identify opportunities.

• Apply analytical best practices to identify indicators of sub-optimal performance and communicate findings to business stakeholders and customers.

• Consistently articulate fact-based, strategic recommendations based on analytical findings.

• Ensure quality of data and analyses while clearly communicating relevant pitfalls and limitations.

• Develop visual analytics that offer interactive self-service reporting capabilities to key business partners.

• Provide statistical rigor to client-facing analyses. Develop and gain alignment on technical definitions for metrics and methods.

Qualifications

Minimum Requirements:

• Business Analyst III requires a BA/BS and minimum of 5 years business analysis experience; or any combination of education and experience which would provide an equivalent background.

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

  Preferred Qualifications:

  Advanced SQL Server and Microsoft Office expertise are a strongly preferred. Intellectual curiosity, superior data mining skills, and the ability to distill financial impacts and levers and communicate them to non-technical audiences is critical to being successful in this role. What will make you stand out versus other candidates? Proven ability to empower analytics-driven business decisions, experience applying statistical concepts, data visualization skills, knowledge of medical claims data, and/or actuarial experience.

• Healthcare experience (e.g., medical insurance, health plan, integrated delivery network) strongly preferred.

• Strong analytical, organizational and problem solving skills preferred.

• Ability to manipulate large data sets, experience with relational databases and knowledge of query tools and statistical software strongly preferred.

• Intermediate SQL and Excel skills strongly preferred.

• RStudio (R, Shiny, ggplot) experience preferred.

• Extensive experience using large, multi-source datasets, especially medical claims data, preferred.

• Focused on developing standardized cost and utilization metrics, making recommendations, and providing assistance to other team members.

  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: PS69306-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?

Services Engineer (Engineer III)

Location: 100% Remote

Our mission is making healthcare services appropriate, safe and affordable. To make this possible, we need talent like yours to help us support innovation and speed to market with our solutions, providing no barriers from technology. AIM Specialty Health is a proud member of the Anthem family of companies and we are looking for technology professionals who are looking to grow their talent and career while helping make a real difference in people's lives.

The Services Engineer (Engineer III) position plays a key role in the development of AIM's platform. This platform powers our specialty care management solutions which support both our health plan partners and the members they cover. We are looking for a new member for our platform development team who will be, along with the team, responsible for all improvements and maintenance of our platform components throughout all phases of our development lifecycle. As developers grow in this role, opportunities exist to grow into team management and architecture roles.

Primary duties for the Services Engineer (Engineer III) role may include, but are not limited to:

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

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

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

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

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

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

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

• Analyzes and evaluates detailed business and technical requirements.

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

• Identifies problems/risks.

• Codes and maintains complex components of information systems.

• Mentors others on coding standards and performs code reviews.

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

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

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

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

Qualifications

Minimum Requirements

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

Preferred Requirements

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

• Proven experience as a Full Stack Developer or similar role

• Minimum 4 years' experience with JAVA; expertise with Spring boot/Spring cloud; or any combination of education and experience, which would provide an equivalent background.

• Minimum 4 years' experience developing web services and deep understanding of SOA principles, HTTP, and REST.

• Minimum 2 years' experience automating build and deployments in AWS using Jenkins CI/CD tools or equivalent.

• Experience and knowledge of front-end frameworks such as NodeJS, AngularJS and/or ReactJS is highly desirable.

• Core understanding of development practices in container environments, such as Docker.

• Core understanding of SOLID principles.

• Demonstrated ability to mentor others, lead small projects and improve team performance

• Demonstrated ability to provide troubleshooting support.

• Excellent communication skills.

• Experience and knowledge of Health Care Industry desired.

• Experience with MongoDB is highly desirable.

• Experience with contact center operations is helpful.

• Experience with numerous design patterns.

• Multi-database, multi-programming language or multi-business application is preferred.

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

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: PS70695-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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

"Telephonic- Nurse Case Manager I/II/Sr (Job Family)

Location: Remote

Hours: Business hours are Monday - Friday 8:00am to 8:00pm EST. 8 hour shifts will be determined.

This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria.

How you will make an impact

Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning.

Primary duties may include, but are not limited to:

• Ensures member access to services appropriate to their health needs.

• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.

• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.

• Coordinates internal and external resources to meet identified needs.

• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.

• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.

• Negotiates rates of reimbursement, as applicable.

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

Qualifications

Nurse Case Mgr I

Minimum Requirements:

• Requires a BA/BS in a health related field; 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 Capabilities, Skills and Experiences:

• Minimum 2 years "telephonic" Case Management experience with a Managed Care Company.

• Minimum 2 years' experience in acute care setting.

• Certification as a Case Manager is preferred.

• Managed Care experience preferred.

• Ability to talk and type at the same time.

• Demonstrate critical thinking skills when interacting with members.

• Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.

• Ability to manage, review and respond to emails/instant messages in a timely fashion.

  Nurse Case Mgr II

  Minimum Requirements:

• Requires a BA/BS in a health related field; 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 Capabilities, Skills and Experiences:

• Minimum 2 years "telephonic" Case Management experience with a Managed Care Company.

• Minimum 2 years' experience in acute care setting.

• Certification as a Case Manager is preferred.

• Managed Care experience preferred.

• Ability to talk and type at the same time.

• Demonstrate critical thinking skills when interacting with members.

• Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.

• Ability to manage, review and respond to emails/instant messages in a timely fashion.

  Nurse Case Mgr Sr

  Minimum Requirements:

• Requires a BA/BS in a health related field; 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 Capabilities, Skills and Experiences:

• Minimum 2 years "telephonic" Case Management experience with a Managed Care Company.

• Minimum 2 years' experience in acute care setting.

• Certification as a Case Manager is preferred.

• Managed Care experience preferred.

• Ability to talk and type at the same time.

• Demonstrate critical thinking skills when interacting with members.

• Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.

• Ability to manage, review and respond to emails/instant messages in a timely fashion.

  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: PS71178-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?

Data Engineer (Engineer II)

Location: 100% Remote

Our mission is making healthcare services appropriate, safe and affordable. To make this possible, we need talent like yours to help us support innovation and speed to market with our solutions, providing no barriers from technology. AIM Specialty Health is a proud member of the Anthem family of companies, and we are looking for technology professionals who are looking to grow their talent and career while helping make a real difference in people's lives.

The Data Engineer (Engineer II) position plays a key role in the development of AIM's data platform. This platform powers our specialty care management solutions which support both our health plan partners and the members they cover. We are looking for a new member for our platform development team who will be, along with the team, responsible for all improvements and maintenance of our data needs for application platform components throughout all phases of our development lifecycle.

Primary duties may include, but are not limited to:

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

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

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

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

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

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

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

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

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

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

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

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

Qualifications

Minimum Requirements

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

Preferred Requirements

• BA/BS degree in Information Technology, Computer Science or related field of study and 5 years related experience preferred.

• Minimum of 2 years hands-on experience with Cloud Technologies like AWS, GCP or Azure.

• Minimum of 3 years hands-on experience with ETL Tool: DataStage, SSIS or similar technologies.

• Strong SQL and analytical skills. Experience developing APIs will be a plus.

• 3+ years of experience with ETL, Data Modeling, Data Warehousing, and working with large-scale datasets

• Experience working in event driven architecture; hands-on experience working with JSON and tool - RabbitMQ

• API Development experience (specifically Rest APIs using Java, Spring boot)

• Technical knowledge in RDMS like Sybase, SQL server Or Oracle

• Experience working with Sybase and MongoDB a plus

• Familiarity with test-driven development, object-oriented programming, and design pattern

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

• Experience in Health Care Domain preferred.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. Please Note: Associates in this job working from a California location are eligible for overtime pay based on California employment law. 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: PS70693-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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

Data Engineer (Engineer II)

Location: 100% Remote

Our mission is making healthcare services appropriate, safe and affordable. To make this possible, we need talent like yours to help us support innovation and speed to market with our solutions, providing no barriers from technology. AIM Specialty Health is a proud member of the Anthem family of companies, and we are looking for technology professionals who are looking to grow their talent and career while helping make a real difference in people's lives.

The Data Engineer (Engineer II) position plays a key role in the development of AIM's data platform. This platform powers our specialty care management solutions which support both our health plan partners and the members they cover. We are looking for a new member for our platform development team who will be, along with the team, responsible for all improvements and maintenance of our data needs for application platform components throughout all phases of our development lifecycle.

Primary duties may include, but are not limited to:

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

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

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

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

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

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

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

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

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

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

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

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

Qualifications

Minimum Requirements

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

Preferred Requirements

• BA/BS degree in Information Technology, Computer Science or related field of study and 5 years related experience preferred.

• Minimum of 2 years hands-on experience with Cloud Technologies like AWS, GCP or Azure.

• Minimum of 3 years hands-on experience with ETL Tool: DataStage, SSIS or similar technologies.

• Strong SQL and analytical skills. Experience developing APIs will be a plus.

• 3+ years of experience with ETL, Data Modeling, Data Warehousing, and working with large-scale datasets

• Experience working in event driven architecture; hands-on experience working with JSON and tool - RabbitMQ

• API Development experience (specifically Rest APIs using Java, Spring boot)

• Technical knowledge in RDMS like Sybase, SQL server Or Oracle

• Experience working with Sybase and MongoDB a plus

• Familiarity with test-driven development, object-oriented programming, and design pattern

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

• Experience in Health Care Domain preferred.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. Please Note: Associates in this job working from a California location are eligible for overtime pay based on California employment law. 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: PS70694-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

This job is for participants of an approved Company internship program for undergraduate college students. Specific work assignments will vary by department. Assignments must meet the definition of meaningful work. Requires enrollment in an Anthem approved academic program in Information Technology, Computer Science or a related field of study. For the Veteran internship, candidates do not need to be students as military experience and training can be substituted for educational 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.

Qualifications

• Currently enrolled in an undergraduate-level degree-seeking program in applied math, statistics, scientific computing, data and analytics, business analytics, or related field

• First or second-year undergraduate student with a graduation date between August 2023 to May 2024.

• GPA of 3.0 or above

• Must be available to participate in the intern program from June to August.

• Advanced user of Excel, PowerPoint, and Word

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work ForR, is ranked as one of the 2020 World's Most Admired Companies among health insurers by Fortune magazine, and a 2020 America's Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS71522

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team!

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

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

The Product Manager will be responsible for the design and implementation of new products within existing market/product lines.

Primary duties may include, but are not limited to: - Evaluates existing products and competitor and industry data to improve existing products and make recommendations for new products. - Recommends and implements long term profitability strategies including market positioning, assessment, pricing parameters, and risk profiles. - Coordinate's presentation, communication and implementation of all phases of product development. - Ensures all products are compliant with regulatory directives and state/federal laws and policies.

Qualifications

- Requires a BA/BS degree in a related field and a minimum of 3 years of related experience; or any combination of education and experience, which would provide an equivalent background. Preferred Qualifications - MBA preferred. Health or managed care 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: PS69701

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team.

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

Responsible for coordinating and consolidating various impact analyses for management reporting. Will support multiple Medicaid markets within the GBD Encounters department with cross functional solutions to increase accuracy and completeness of encounter submissions to State Agencies.

Primary duties may include, but are not limited to:

• Establishes, improves, and optimizes the consolidating processes for forecast and month-end results.

• Consolidates and prepares executive summary reports for various business segments in the SBU for top management decision-making.

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

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

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

• May coordinate with external audits as appropriate.

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

Qualifications

Minimum Requirements:

• Requires a BS/BA degree in Statistics, Economics, or Business Administration and minimum of 12 years of relevant experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• Experience providing leadership in evaluating financial performance of complex organizations strongly preferred.

• Preferred experience with EDIFECs software, SQL data analysis, and EDI transactions with a primary focus on 837 encounter format and processing.

• Excellent leadership, problem solving, organizational, planning, presentation and interpersonal skills strongly preferred.

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

  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: PS70634

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?

PBM Compliance Manager

Responsible for coordinating pharmacy compliance activities and initiatives across the PBM and the enterprise by maintaining department approved regulatory and legislative compliance plan and implementing effective internal controls.

How you will make an impact::

• Identifies, monitors, revises and tracks business unit processes and implementing procedures to ensure compliance with all related measures.

• Identifies potential risks associated with PBM activities and ensures procedures are in place to minimize risks.

• Partners with business units to ensure compliance with all statutory and regulatory requirements.

• Participates as compliance subject matter expert on all mandated projects; achieves business operational compliance with all related measures relative to HIPAA and SOX and Privacy and Security Office initiatives.

• Conducts, directs, leads and facilitates all activities related to Internal and External (Regulatory and Client) audits and responds to findings.

• Performs high level regulatory research, develops strategic plans and pro-actively anticipates business needs and requirements.

• Develops and implements training and communication plans; manages and leads scheduled and ad-hoc compliance projects; provides and delivers compliance consultation services to the business unit.

Qualifications

• Requires a BA/BS and minimum of 6 years experience; or any combination of education and experience, which would provide an equivalent background. MS/MBA or field related professional designation 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: PS71406-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

The Information Technology Intern students will gain real-world work experience in their academic field. During the summer months, interns will engage in challenging projects evolving around the rapidly changing healthcare tech industry. Interns will be paired with industry professionals and mentors and will be given opportunities to stretch their skills and enrich their knowledge base to achieve a greater understanding of Technology. If the intern performs well throughout the internship, there will be opportunities for full-time employment once the intern undergraduates.

Interns will participate in activities to enhance the connection to the company as a whole and encourage personal growth. Some of these activities include:

• Formal onboarding event for all students to ensure integration to the organization and program

• A one on one mentorship with a leader for the duration of the program

• Cadenced Learning series to build student's acumen and focus on learning the business

• Opportunities to grow and develop through social and networking events

  What we are looking for:

Analytics Interns will be assigned to a specific group within Digital and Information Technology based on the skillset and needs of the business. Undergraduate students should have experience and education in:

• Python, R, Java, C/C++, C#, Angular, HTML

• Working on public cloud (AWS, Azure, or GCP)

• Knowledge of SAS SQL Databases, database modeling, and other Querying languages

• Experience in writing solutions using Python & SQL

• Text Analytics and Natural Language Processing, Sequence Labeling

• Knowledge of Data Science & Artificial Intelligence/Machine learning, Probabilistic and Statistical Learning Methods

• Strong communication and cross-functional collaboration skills

The Summer 2022 Internship will take place from June 6th - August 12th. We have four Summer Intern Roles we are looking to fill.

This is a remote opportunity. The ideal person will possess the willingness and capacity to learn quickly and apply new knowledge. They will also have proven analytical skills, excellent written and oral communication abilities. We are in search of an energetic self-starter with a willingness to work hard, take on significant and multiple responsibilities, and with dedication towards excellence and achieving results. We want to hear from you!

Qualifications - External

• Currently enrolled in an undergraduate-level degree-seeking program in applied math, statistics, scientific computing, data and analytics, business analytics, or related field

• First or second-year undergraduate student with a graduation date between August 2023 to May 2024.

• GPA of 3.0 or above

• Must be available to participate in the intern program from June to August.

• Advanced user of Excel, PowerPoint, and Word

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work ForR, is ranked as one of the 2020 World's Most Admired Companies among health insurers by Fortune magazine, and a 2020 America's Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS71520

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team.

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

Responsible for coordinating and consolidating various impact analyses for management reporting. Will support multiple Medicaid markets within the GBD Encounters department with cross functional solutions to increase accuracy and completeness of encounter submissions to State Agencies.

Primary duties may include, but are not limited to:

• Establishes, improves, and optimizes the consolidating processes for forecast and month-end results.

• Consolidates and prepares executive summary reports for various business segments in the SBU for top management decision-making.

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

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

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

• May coordinate with external audits as appropriate.

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

Qualifications

Minimum Requirements:

• Requires a BS/BA degree in Statistics, Economics, or Business Administration and minimum of 12 years of relevant experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• Experience providing leadership in evaluating financial performance of complex organizations strongly preferred.

• Preferred experience with EDIFECs software, SQL data analysis, and EDI transactions with a primary focus on 837 encounter format and processing.

• Excellent leadership, problem solving, organizational, planning, presentation and interpersonal skills strongly preferred.

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

  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: PS70634-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

The Information Technology Intern students will gain real-world work experience in their academic field. During the summer months, interns will engage in challenging projects evolving around the rapidly changing healthcare tech industry. Interns will be paired with industry professionals and mentors and will be given opportunities to stretch their skills and enrich their knowledge base to achieve a greater understanding of Technology. If the intern performs well throughout the internship, there will be opportunities for full-time employment once the intern undergraduates.

Interns will participate in activities to enhance the connection to the company as a whole and encourage personal growth. Some of these activities include:

• Formal onboarding event for all students to ensure integration to the organization and program

• A one on one mentorship with a leader for the duration of the program

• Cadenced Learning series to build student's acumen and focus on learning the business

• Opportunities to grow and develop through social and networking events

  What we are looking for:

Analytics Interns will be assigned to a specific group within Digital and Information Technology based on the skillset and needs of the business. Undergraduate students should have experience and education in:

• Python, R, Java, C/C++, C#, Angular, HTML

• Working on public cloud (AWS, Azure, or GCP)

• Knowledge of SAS SQL Databases, database modeling, and other Querying languages

• Experience in writing solutions using Python & SQL

• Text Analytics and Natural Language Processing, Sequence Labeling

• Knowledge of Data Science & Artificial Intelligence/Machine learning, Probabilistic and Statistical Learning Methods

• Strong communication and cross-functional collaboration skills

The Summer 2022 Internship will take place from June 6th - August 12th. We have four Summer Intern Roles we are looking to fill.

This is a remote opportunity. The ideal person will possess the willingness and capacity to learn quickly and apply new knowledge. They will also have proven analytical skills, excellent written and oral communication abilities. We are in search of an energetic self-starter with a willingness to work hard, take on significant and multiple responsibilities, and with dedication towards excellence and achieving results. We want to hear from you!

Qualifications

• Currently enrolled in an undergraduate-level degree-seeking program in applied math, statistics, scientific computing, data and analytics, business analytics, or related field

• First or second-year undergraduate student with a graduation date between August 2023 to May 2024.

• GPA of 3.0 or above

• Must be available to participate in the intern program from June to August.

• Advanced user of Excel, PowerPoint, and Word

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work ForR, is ranked as one of the 2020 World's Most Admired Companies among health insurers by Fortune magazine, and a 2020 America's Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS71521

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Grievance/Appeals Analyst I

Remote (anywhere within 50 miles of 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?

How you will make a difference:

This is an entry level position in the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non clinical services, quality of service, and quality of care issues to include executive and regulatory grievances. Primary duties may include, but are not limited to:

• Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language.

• Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing and/or medical staff for review.

• The grievance and appeal work is subject to applicable accreditation and regulatory standards and requirements.

• As such, the analyst will strictly follow department guidelines and tools to conduct their reviews.

• The file review components of the URAC and NCQA accreditations are must pass items to achieve the accreditation.

• Analyzes and renders determinations on assigned non-complex grievance and appeal issues and completion of the respective written communication documents to convey the determination.

• Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information.

• The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments.

Qualifications

Minimum Requirements:

• HS diploma or GED and a minimum of 3 years experience working in grievances and appeals, claims, or customer service; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, the company's internal business processes, and internal local technology is strongly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

  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: PS70524-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?

Build the possibilities. Make an extraordinary impact:

Responsible for serving as an expert in data analysis, reporting and formulating recommendations and providing guidance to other data analysts.

How you will make an impact:

• Creates and maintains databases to track business performance.

• Analyzes data and summarizes performance using summary statistical procedures.

• Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.

• Creates and publishes periodic reports, as well as any necessary ad hoc reports.

• May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

• May make recommendations based upon data analysis.

• Provides analytic consultation to other business areas, leadership or external customers.

• Data analysis and reporting encompasses a much higher level of complexity.

Qualifications

Minimum Requirements:

• Requires a BS/BA degree in related field and a minimum of 5 years experience; or any combination of education and experience which would provide an equivalent background.

• Experience with relational databases and knowledge of query tools and statistical software is strongly preferred.

• Ability to manipulate large sets of data strongly preferred.

• Strong analytical, organizational, presentation, and problem solving skills strongly preferred.

Preferred Skills, Capabilities and Experience:

• Strong experience with SQL and SQL Coding are highly desirable.

• Competency with interpreting technical documentation and writing requirements is highly preferred.

• Intermediate to advanced proficiency in MS office products, particularly advanced Excel skills working with large datasets.

• Experience in FACETS, Oracle, Access and familiarity with JIRA/SNOW processes is a plus.

• MMP/Duals experience and an understanding of Medicaid and/or Medicare is preferred.

• The ability to quickly assess, analyze and synthesize data coming from multiple locations and sources into one comprehensive process is highly preferred.

• The ability to successfully present information in a consolidated, concise and thoughtful manner is preferred.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. 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: PS70838-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?

Build the Possibilities. Make an extraordinary impact.

Manages processes for ensuring company and its subsidiaries are informed of applicable laws and regulations.

How you will make an impact:

• Develops, implements, and maintains processes for reviewing information about new laws and regulations and changes in interpretation on laws and regulations obtained from various sources.

• Serves as subject matter expert on laws and regulations that impact the business.

• Performs original research on points of law that may arise as issues of concern.

• Develops, implements, and maintains process for drafting policies and procedures that address any new or changed laws or regulations.

• Interacts with legal department to review and evaluate policies and procedures.

• Develops, implements, and maintains process for coordinating with accreditation, quality management, clinical adherence, and operational areas to ensure department output is in alignment with company's overall objectives.

Qualifications

Minimum Requirements:

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

Preferred Skills, Capabilities and Experiences:

• Legal training and education preferred.

• Knowledge of applicable accreditation requirements 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: PS71057-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?

Build the possibilities. Make an extraordinary impact:

Responsible for serving as an expert in data analysis, reporting and formulating recommendations and providing guidance to other data analysts.

How you will make an impact:

• Creates and maintains databases to track business performance.

• Analyzes data and summarizes performance using summary statistical procedures.

• Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.

• Creates and publishes periodic reports, as well as any necessary ad hoc reports.

• May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

• May make recommendations based upon data analysis.

• Provides analytic consultation to other business areas, leadership or external customers.

• Data analysis and reporting encompasses a much higher level of complexity.

Qualifications

Minimum Requirements:

• Requires a BS/BA degree in related field and a minimum of 5 years experience; or any combination of education and experience which would provide an equivalent background.

• Experience with relational databases and knowledge of query tools and statistical software is strongly preferred.

• Ability to manipulate large sets of data strongly preferred.

• Strong analytical, organizational, presentation, and problem solving skills strongly preferred.

Preferred Skills, Capabilities and Experience:

• Extensive experience with SSIS is highly desirable.

• Strong experience with SQL Server and Tableau are highly preferred.

• Experience or exposure to AI is highly preferred.

• Experience or exposure Python is highly preferred.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70930-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Medical Policy Regional Coordinator Schedule: Monday-Friday; 8am-5pm (Work your own time zone) Location: Remote with 10% travel

Be part of an extraordinary team

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

Duties & Responsibilities Responsible for serving as the link and quality assurance mechanism between the Corporate Medical Policy PMO and regional plan operations. Primary duties may include, but are not limited to managing and assisting: - Assures enterprise objectives for timely implementation and risk management are met; assures regional requirements are represented in the development of enterprise policy. - Assures PMO activities are conducted to support the achievement of regional business plans objectives. - Oversees and tracks local/regional implementation of policy. - Identifies key local stakeholders in systems, medical management, provider relations, marketing, and government relations. - Establishes effective working relationships and communications processes. Demonstrating solutions and initiative with minimal supervision and oversight. - Identifies local issues and systems and operational issues, and oversees, supports, and conducts local training. - Manage processes and develop optimized solutions/efficiencies using technology to coordinate, track, report in areas that may include but not be limited to: Handling consultant Questionnaire's with Academic Medical Centers, physician groups, and state medical societies; Medical Policy & Technology Assessment Agenda and materials management, Independent appeals collection and reporting, department inquiry management, and other processes within the department dependent on changing resource needs. - Assist as needed and as expertise develops to manage, coordinate, facilitate and optimize the process for testing the MCG updates/customization UAT and go live (after business hours) testing for the enterprise. - Develop and optimize reports on department information using excel, access, and working with business partners for developing enterprise tools. - Contribute and as needed assist to oversee the content management in WCS, Anthems enterprise content management system and participate in department QA of uploads to internal and external websites. Assist as needed with health related social needs (HRSN) materials and publications internally and externally if needed.

Qualifications

Requirements - BA/BS degree in a related field and a minimum of 5 years related experience; or any combination of education and experience which would provide an equivalent background. - Ability to travel may be required at 10% to a local office for training or for committee in person meeting management.

Strongly Preferred - Prefer-background with collaborative teams and developing materials for external use. - Clinical background or demonstrated understanding of Anthem medical policies. - Ability to demonstrate proficiency with Microsoft office tools specifically technical expertise in excel. - Experience using pivot tables, formulas and linking information for reporting. Experience in analyzing and managing large volumes of information on a daily basis. - Self-motivated, results driven individual with a strong attention to detail and a demonstrated ability to independently focus and manage multiple complex and technical tasks in a fluid environment with minimal supervision and oversight. - Must also be willing to do repetitive tasks and processes and show ongoing drive for results with a sense of urgency. - Must be willing to do testing after the usual business hours once to twice a year.

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: PS70543-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? Build the Possibilities. Make an extraordinary impact. Join our AIM Specialty Health team as our Next Medical Director who will be responsible for leading and ensuring the clinical integrity and efficient, compliant delivery of AIM solutions to all clients with Medicare lines of business including Medicare Advantage.

AIM Specialty Health is a benefit-management leader in Illinois and a proud member of Anthem's family of companies. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology, and oncology.

Remote Opportunity - Monday through Friday (Central Business Hours) - Some travel may be required

Responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. Primary duties may include, but are not limited to: - Supports clinicians to ensure timely and consistent responses to members and providers. Provides guidance for clinical operational aspects of a program. - Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians. - May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations. - Serves as a resource and consultant to other areas of the company. - May be required to represent the company to external entities and/or serve on internal and/or external committees. - May chair company committees. - Interprets medical policies and clinical guidelines. - May develop and propose new medical policies based on changes in healthcare. - Leads, develops, directs and implements clinical and non-clinical activities that impact health care quality cost and outcomes. - Identifies and develops opportunities for innovation to increase effectiveness and quality. - This level may provide oversight, direction and guidance to Medical Director Associates. - Works independently with oversight from immediate manager. - May be responsible for an entire clinical program and/or independently performs clinical reviews. - The Medical Director typically has program management responsibilities including clinical policy development, program development/implementation, and overseeing clinical/non-clinical activities.

Qualifications

Minimum Requirements - Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) in Internal Medicine, Family Medicine, Emergency Medicine. - Must possess an active unrestricted medical license to practice medicine or a health profession in any state. - Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. - Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. - For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.

Preferred Requirements - Medicare/Medicaid program experience strongly preferred. - Willing to learn new technologies to support access to National and Local Coverage Determinations (NCDs and LCDs). - Familiarity with clinical decision support desirable but not required. - Managed care knowledge strongly preferred. - Must be familiar with Microsoft Word, Excel, Power Point and Visio. - Must be familiar with standard medical coding schemes (ICD-10,HCPCS, CPT-4)

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: PS71175-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team:

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

Build the possibilities. Make an extraordinary impact:

Responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics. Typically provides technical assistance to lower level staff.

How you will make an impact:

• Creates and maintains databases to track business performance.

• Analyzes data and summarizes performance using summary statistical procedures.

• Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.

• Creates and publishes periodic reports, as well as any necessary ad hoc reports.

• May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

• May make recommendations based upon data analysis.

Qualifications

Minimum Requirements:

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

• Experience with relational databases and knowledge of query tools and statistical software is strongly preferred.

• Ability to manipulate large sets of data is strongly preferred.

• Strong analytical, organizational and problem solving skills are strongly preferred.

Preferred Skills, Capabilities and Experience:

• Strong SQL Server and Tableau experience is highly preferred.

• SSIS knowledge is desirable.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70929-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Provider Contract Specialist Sr

New York, New Jersey, or Connecticut preferred

Be a part of an extraordinary team

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

Build the Possibilities. Make an extraordinary impact.

Your Talent. Our Vision. At Anthem, Inc., it's powerful combination, and the foundation upon which we're creating greater access to care for our members., great value for our customers, and great 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.

The Provider Contract Specialist Sr position is responsible for coordinating the process for more complex pricing arrangements involving high profile provider groups and/or physician groups tied to large hospital systems joining the network including creating standard contracts for providers as needed. Functions with the expertise in managing negotiated pricing loads.

Primary duties may include, but are not limited to:

• Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery system.

• Prepare the information for timely and accurate submission to the Provider Data Management area.

• Ensure updates/changes for existing network providers are interpreted and loaded accurately.

• Ensure accurate and timely loading of professional and facility contracts across value based and fee for service agreements for provider solutions.

• Works directly with contracting directors and managers to understand what is negotiated and how the negotiated agreement is translated into the company's systems resulting in accurate and timely loading.

• Performs internal audit of provider record, ensuring accuracy against rosters.

• Serves as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround.

• Serve as local market expert supporting (and managing when necessary) the provider onboarding process and provider updates submitted by provider offices within defined market.

• Must possess critical thinking skills, have a proven strong eye for detail and a focus on quality.

Qualifications

Minimum Requirements:

• Requires a H.S. diploma and a minimum of 5-years' experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background.

  Preferred Requirements:

• Microsoft Word, Excel, and Outlook 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: PS70129-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team:

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

Build the possibilities. Make an extraordinary impact:

Responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics. Typically provides technical assistance to lower level staff.

How you will make an impact:

• Creates and maintains databases to track business performance.

• Analyzes data and summarizes performance using summary statistical procedures.

• Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.

• Creates and publishes periodic reports, as well as any necessary ad hoc reports.

• May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

• May make recommendations based upon data analysis.

Qualifications

Minimum Requirements:

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

• Experience with relational databases and knowledge of query tools and statistical software is strongly preferred.

• Ability to manipulate large sets of data is strongly preferred.

• Strong analytical, organizational and problem solving skills are strongly preferred.

Preferred Skills, Capabilities and Experience:

• Strong SQL Server and Tableau experience is highly preferred.

• Experience or exposure with AI is desirable.

• SSIS knowledge is desirable.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70321-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Responsible for management oversight of receipt, investigation and processing associated with member/provider grievance and appeals.

How you wil make an impact:

• Monitors, trends and analyzes grievance and appeals data for submission to appropriate parties.

• Serves as clinical resource expert and mentor to unit and other departments for complex issues and interpretation of regulatory standards, accreditation standards and client specific guarantees.

• May perform internal audits of grievance and appeals process.

• Ensures appeals and grievances are resolved within regulatory and performance guarantee timeframes.

• Works with Account Management and National Clients as needed.

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

Qualifications

Minimum Qualifications:

• Requires a minimum of 3 years leadership experience in grievance & appeals, claims or customer services in the healthcare industry; or any combination of education and experience which would provide an equivalent background.

• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.

Preferred Skills, Capabilities and Experience:

• BA/BS preferred.

• WGS

• Next GEN

  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: PS71104-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?

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

Primary duties may include, but are not limited to:

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

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

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

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

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

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

• Analyzes and evaluates detailed business and technical requirements.

• Understands the product and analytics and drive requirements that take into account stakeholders needs. Identifies problems/risks.

• Codes and maintains complex components of information systems.

• Mentors others on coding standards and performs code reviews.

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

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

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

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

Qualifications

Minimum Requirements:

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

Preferred Qualifications:

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

• Experience with SQL, Oracle, Excel and Facets is preferred.

• Incumbent should also have the ability to mentor others, lead small projects and provide troubleshooting support.

• Three or more (3+) years Pega experience and PEGA System Architect certification are preferred.

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

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS70495-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?

The Manager II Technology is responsible for maintaining Information Technology (IT) strategies by researching and implementing technological strategic solutions to ensure the streamlined operation of the IT department.

Primary duties may include, but are not limited to:

• Oversees information systems function for a site, system, or special initiative.

• Manages multiple cost centers and/or plan of record projects; delivers and supports software system solutions that support the operations of their functional areas.

• Manages at least a single application (or the equivalent capital and/or level of responsibility and complexity).

• Evaluates all directives, change orders, and projects as to their impact on tactical plans, budgets, and contract compliance.

• Oversees and implements new subsystems, procedures and techniques; manages implementation/integration projects to ensure deliverables.

• Establishes and maintains collaborative relationships with key business partners.

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

Qualifications

Minimum Requirement:

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 5 years of experience leading project teams, application software development, maintenance or implementation and support, including 3 years of management or leadership 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: PS70972

Job Detail

• Company:
  Anthem, Inc.