Company Detail

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?The Staff VP Account Management, IngenioRX, is responsible for implementing and onboarding new sales, delivering client retention and satisfaction strategies that drive results and improving operating gain by organic and product portfolio expansion. This position provides leadership for Pharmacy Services with management oversight of all of the Account Executives, Account Managers and other account facing staff within a specified region and leads Pricing Strategies for renewal business and product expansions. This position engages significantly with matrixed resources (Clinical, Operations, Pricing, Product, etc.) that support accounts served. In this capacity, the position works directly with the VP & CSO IngenioRx to ensure successful alignment of pharmacy services team efforts in support of business objectives, creating the joint pharmacy strategy for all customers served to drive growth, retention and ongoing profitability. Primary interfaces include Integrated Segment resources such as the Sales team, Pharmacy Clinical Account Services, Marketing, the pricing team, Underwriting, Product and Medical Account Services, and Pharmacy Operations, Analytics, and Compliance. This position will also have significant engagement with CSBD leadership, including regional leaders, Plan Presidents, along with ANA leadership and staff. Expectations - Ownership of all Integrated client relationships, contract performance and growth - Development of segment and account specific strategic plans that address client priorities, relationship management and IngenioRx success - Retain and grow revenue and op gain year over year for all Integrated business - Address all issues that contribute to customer satisfaction - Support the implementation of broker/consultant strategies by market - Identify, prioritize and lead internal improvement efforts with stakeholders that will allow Account Management to focus on retaining, selling and other key priorities in a scalable manner - Advocate for the formulation of strategic product options (ex: formulary and retail networks) by market needed to grow and retain - Evaluate new opportunities for revenue growth such as new product expansions - Able to develop immediate credibility and long-term consultative relationships with Pharmacy Sales/Account Directors, and all IngenioRx cross functional partners/resources that support the Integrated business - Exceed the retention, satisfaction and product expansion goals by focusing on key opportunities and relationships - High quality service focusing on customer requirements and installations for a large group of clients - Recruiting, motivating and retaining high quality account team resources. - Developing consultative and business acumen skills for the account client-facing organization. - Leveraging skills to refine the Integrated IngenioRx value proposition into successful market-facing messages to both existing clients and consultants. Primary Responsibilities - Develop and champion pharmacy account management vision, mission, strategy, and group objectives. - Partner with current client base to assure retention, satisfaction and growth within a highly accountable and visible framework focused on driving results to plan. - Develop executive level relationships (higher-wider-deeper) directly as well as drives plan execution throughout the organization. - Collaborate with the Pharmacy Benefits Manager (PBM) to ensure connectivity and alignment so that client expectations are met. Additionally, work with PBM to obtain customization or services when required for retention or expansion of existing clients. - Provide executive leadership for the development of training materials/forums to educate Account Mgmt. associates on IngenioRx products and how to effectively sell groups on the pharmacy value proposition. - Provide executive leadership for renewing client proposals, pricing, repricing. - Communicate pharmacy account issues in the context of overall healthcare and serve as a direct resource for client-specific concerns. - Maintain ongoing opportunities for sharing of best-practices among Pharmacy Services team and promote an efficient account service model. - Evaluate, coach, and mentor staff. - Identify opportunities for product improvement to meet the needs of clients and advocate for appropriate change. - Maintain positive senior level relationships with clients, IngenioRx cross functional leaders and other key CSBD leaders. - Client management and retention - client satisfaction results for clinical services, superior client retention rate, long-term client relationships - People management - employee satisfaction, growth and retention - Collaborate with pharmacy clinical staff in evaluating prospective client claims data to identify clinical opportunities to leverage in the product expansion and renewal process. - Attend select best & final presentations to supplement the prospective account team. - Drive pharmacy product and growth in partnership with business owners.

Qualifications

- Bachelor's degree required, Master's degree preferred or any equivalent combination of experience and education - Minimum 10 years of progressively responsible PBM Account Management, Sales or Operations experience in the managed care industry - Must have experience in account management principles - Business, Clinical and Operational acumen

Skills, Capabilities & Experience

• MBA

• Experience with PBM pricing

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.

Annual Salary Range*: $168,000 - $210,000

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

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

  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: PS69690-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team.

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

The 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-Virginia

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Health Coach/ Sr

Will work onsite at client location in Arlington Virginia

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

Responsible for providing health coaching to members, across all brands, with chronic diseases.

How you will make an impact:

• Behavioral assessments to identify individual member knowledge, skills, and behavioral needs.

• Coordinates specific health coaching to address objectives and goals as identified during assessment.

• Implements coaching plan by using behavior change principles to identify member barriers and develop ways to overcome those barriers.

• Coordinates to provide feedback on member goal attainment and clinical issues as needed

• Monitors and evaluates the interventions and modifies when necessary

• Develops and delivers wellness promotion programming and activities in the form of group activities, webinars, educational material, and challenges for example

Qualifications

Health Coach

Minimum Qualifications:

• Requires BA/BS in appropriate field of specialization (examples such as Health Education, Exercise Physiology, Respiratory Therapy or Dietician) and minimum of 3 years of related experience in health education, fitness/ exercise instruction, or patient education; or any combination of education and experience, which would provide an equivalent background. Certification, advanced certification, and/or license appropriate to field of specialty as required.

Preferred Skills, Capabilities and Experience:

• Prior experience in health coaching, disease management and knowledge of behavioral and/or clinical assessment techniques, health and/or patient education and behavior change techniques preferred.

• Understanding of disease management principles preferred.

Health Coach Sr

Minimum Qualifications:

• Requires BA/BS in appropriate field of specialization (examples such as Health Education, Exercise Physiology, Respiratory Therapy or Dietician) and minimum of 5 years of related experience in health education, exercise instruction or patient education; or any combination of education and experience, which would provide an equivalent background. Certification, advanced certification, and/or license appropriate to field of specialty as required.

Preferred Skills, Capabilities, and Abilities:

• Prior experience in health coaching, disease management and knowledge of behavioral and/or clinical assessment techniques, health and/or patient education and behavior change techniques preferred.

• Understanding of disease management principles

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: PS71315-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 Financial Operations Recovery Process Specialist is responsible for working with Business Consultants with the ongoing expansion of the Global Workforce within the Pre Payment and Post Payment CSBD Validation teams. Also responsible for providing technical direction, guidance and resources to associates on a day to day basis.

Primary duties may include, but are not limited to:

• Serves as a first line resource for financial operations associates for workflow and technical related processes.

• Provides operational training, assists associates by answering day-to-day technical questions, monitors inventory to ensure workflow remains uninterrupted, and handles complex case research and resolution.

• May review and monitor associates work for quality standards.

• Reviews department policy and procedure manuals for accuracy and works to ensure procedures and polices are accurate and complete.

• May research operations workflow problems and system irregularities.

• Assists with the development and testing of process improvement solutions and other operational improvements.

Qualifications

Primary requirements:

• Requires a BA/BS

• Minimum of 3 years related experience

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

• WGS Claims knowledge required.

Preferred requirements:

• Previous experience in high-volume operations (claims, customer service, enrollment and billing) strongly preferred.

• Prior mentoring and training experience in a virtual setting strongly preferred

• Excellent listening skills with the ability to verbalize for understanding

• Knowledge of Legacy Claims Platforms ACES, CHIPS, CS90, FACETS, NASCO 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: PS71012

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 Staff VP Account Management, IngenioRX, is responsible for implementing and onboarding new sales, delivering client retention and satisfaction strategies that drive results and improving operating gain by organic and product portfolio expansion. This position provides leadership for Pharmacy Services with management oversight of all of the Account Executives, Account Managers and other account facing staff within a specified region and leads Pricing Strategies for renewal business and product expansions. This position engages significantly with matrixed resources (Clinical, Operations, Pricing, Product, etc.) that support accounts served. In this capacity, the position works directly with the VP & CSO IngenioRx to ensure successful alignment of pharmacy services team efforts in support of business objectives, creating the joint pharmacy strategy for all customers served to drive growth, retention and ongoing profitability. Primary interfaces include Integrated Segment resources such as the Sales team, Pharmacy Clinical Account Services, Marketing, the pricing team, Underwriting, Product and Medical Account Services, and Pharmacy Operations, Analytics, and Compliance. This position will also have significant engagement with CSBD leadership, including regional leaders, Plan Presidents, along with ANA leadership and staff. Expectations - Ownership of all Integrated client relationships, contract performance and growth - Development of segment and account specific strategic plans that address client priorities, relationship management and IngenioRx success - Retain and grow revenue and op gain year over year for all Integrated business - Address all issues that contribute to customer satisfaction - Support the implementation of broker/consultant strategies by market - Identify, prioritize and lead internal improvement efforts with stakeholders that will allow Account Management to focus on retaining, selling and other key priorities in a scalable manner - Advocate for the formulation of strategic product options (ex: formulary and retail networks) by market needed to grow and retain - Evaluate new opportunities for revenue growth such as new product expansions - Able to develop immediate credibility and long-term consultative relationships with Pharmacy Sales/Account Directors, and all IngenioRx cross functional partners/resources that support the Integrated business - Exceed the retention, satisfaction and product expansion goals by focusing on key opportunities and relationships - High quality service focusing on customer requirements and installations for a large group of clients - Recruiting, motivating and retaining high quality account team resources. - Developing consultative and business acumen skills for the account client-facing organization. - Leveraging skills to refine the Integrated IngenioRx value proposition into successful market-facing messages to both existing clients and consultants. Primary Responsibilities - Develop and champion pharmacy account management vision, mission, strategy, and group objectives. - Partner with current client base to assure retention, satisfaction and growth within a highly accountable and visible framework focused on driving results to plan. - Develop executive level relationships (higher-wider-deeper) directly as well as drives plan execution throughout the organization. - Collaborate with the Pharmacy Benefits Manager (PBM) to ensure connectivity and alignment so that client expectations are met. Additionally, work with PBM to obtain customization or services when required for retention or expansion of existing clients. - Provide executive leadership for the development of training materials/forums to educate Account Mgmt. associates on IngenioRx products and how to effectively sell groups on the pharmacy value proposition. - Provide executive leadership for renewing client proposals, pricing, repricing. - Communicate pharmacy account issues in the context of overall healthcare and serve as a direct resource for client-specific concerns. - Maintain ongoing opportunities for sharing of best-practices among Pharmacy Services team and promote an efficient account service model. - Evaluate, coach, and mentor staff. - Identify opportunities for product improvement to meet the needs of clients and advocate for appropriate change. - Maintain positive senior level relationships with clients, IngenioRx cross functional leaders and other key CSBD leaders. - Client management and retention - client satisfaction results for clinical services, superior client retention rate, long-term client relationships - People management - employee satisfaction, growth and retention - Collaborate with pharmacy clinical staff in evaluating prospective client claims data to identify clinical opportunities to leverage in the product expansion and renewal process. - Attend select best & final presentations to supplement the prospective account team. - Drive pharmacy product and growth in partnership with business owners.

Qualifications

- Bachelor's degree required, Master's degree preferred or any equivalent combination of experience and education - Minimum 10 years of progressively responsible PBM Account Management, Sales or Operations experience in the managed care industry - Must have experience in account management principles - Business, Clinical and Operational acumen

Skills, Capabilities & Experience

• MBA

• Experience with PBM pricing

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.

Annual Salary Range*: $168,000 - $210,000

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

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

  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: PS69690-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 identifying opportunities for improvement, developing and implementing best practice and continuous improvement initiatives for a business unit.

How you will make a difference:

• Proactively identify opportunities for improvement; research, develop, and implement related best practices.

• Develop metrics to track performance and goal achievement.

• Be a thought leader on improvement initiatives.

• Identify and develop plans to improve performance to be incorporated enterprise wide.

• Lead high level of effort projects with leaders within the organization

• Remove roadblocks to ensure successful project execution

• May travel, as needed.

Qualifications

Minimum Requirements:

Requires a BA/BS in a related field and minimum of 10 years of process improvement experience with planning, project management, business analysis, and leadership role experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• 3+ years' experience working in Medicare and at a matrixed organization.

• Six Sigma Black Belt certification.

• Experience working with and presenting to senior leaders

  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: PS70645-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.

The IS Advisor - Data Monitoring and Protection Services is a strategic role partnering to drive Strategic Planning, Program Oversight, Business alignment and support, and Data Loss Prevention governance across the Data Loss Prevention program. As an Advisor, you will help shape the Data Loss Prevention direction by applying data analysis, skills, tools, and techniques and leadership strategy to directly influence the success of the team's expansion of services.

A successful candidate should demonstrate success as a proactive leader with a track record of delivering results for large-scale initiatives. Key to your success will be the ability to navigate the complexities of a large organization, and a relentless drive to confront and resolve issues and, as applicable, see solutions scale across the program. You will be looked to as a trusted partner and problem solver, helping all stakeholders overcome obstacles and guiding solutions forward.

How you will make an impact:

• Daily working knowledge of Data Loss Prevention (DLP) technology for user endpoints, such as laptops and/or VDAAS (any vendor) and Cloud vendors including Netskope or O365 Compliance

• Provides advanced level engineering design for Symantec products and services including DLP controls impact to enterprise, including deployment, configuration, engineering and administration of the security infrastructure and application

• Provides technical guidance and leadership to Program engineers

• Proposes opportunities to improve results based on targeted or continuous assessment

• Assists in process and project management

• Ensures and reviewing appropriate testing practices

• Drives problem management

• Represents major upgrades and business system replacements to leadership and provides strategy inputs

• Establishes vendor relationships for Symantec products and services and ensures product-related issues are resolved

• Creates presentations and seeks management approval and acceptance

• Routinely acts as a subject matter expert for management

• Tracks, documents, and communicates team metrics, accomplishments, and successes.

• Builds partnerships across the enterprise

• Assists in the annual review of Information Security Policies and Program documents to include updates related to continued program maturation and evolution.

• Support the creation, review and delivery of messaging and responses for expansion, and ad-hoc assessments.

Qualifications

Minimum Requirements:

Requires BS/BA degree in Information Technology or related field of study and a minimum of 5 years experience in systems support, system administration, system engineering, system security, access management, network security, network communications, computer networking, telecommunications, systems development and management, hardware, software, and/or data; or any combination of education and experience, which would provide an equivalent background. Requires experience in planning and designing highly complex systems. Experience with multiple technical and business disciplines strongly preferred. Security Certifications: CISSP or other technical security certifications (e.g. Systems Security Certified Practitioner, Certification and Accreditation Professional) strongly preferred. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed

Preferred Skills, Capabilities and Experiences:

A successful candidate should demonstrate success as a proactive leader with a track record of delivering results for large-scale initiatives. Key to your success will be the ability to navigate the complexities of a large organization, and a relentless drive to confront and resolve issues and, as applicable, see solutions scale across the program. You will be looked to as a trusted partner and problem solver, helping all stakeholders overcome obstacles and guiding solutions forward.

Working knowledge of Data Loss Prevention (DLP) technology for user endpoints, such as laptops and/or VDAAS (any vendor) and Cloud vendors including Netskope or O365 Compliance

• Experience working in a large organization

• Project management experience

• Financial, Insurance or Healthcare industry experience

• Relevant industry certification such as CISSP, CISM, CRISC or similar

  (CO Colorado Pay)

  Applicable to Colorado Applicants Only

  Annual Salary Range*: $98,000 - $122,000

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

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

  REQNUMBER: PS70117

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 Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Primary duties may include, but are not limited to:

• Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.

• Determines and calculates amount of overpayments and processes refunds.

• Researches voluntary refunds for accuracy.

• Requires accurate balancing of all accounts.

• Responsible for more routine issues.

• May work with internal staff from other departments to ensure customer satisfaction.

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

Qualifications

Finance Operations Recovery Specialist I primary requirements:

• Requires a H.S. diploma

• Minimum of 1 year of claims processing and/or customer service experience

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

Finance Operations Recovery Specialist I preferred requirements:

• AA/AS preferred.

• WGS/claims 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: PS70829

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

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

Location: Remote (100%)

Responsible for analyzing, reporting and developing recommendations on data related to multiple, varied business metrics.

Primary duties may include, but are not limited to:

• 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, makes necessary recommendations, and develops ad hoc reports as needed.

• 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.

Qualifications

Minimum Qualification:

• Requires a BS/BA degree in related field and a minimum of 2 years related operational and/or data analysis experience, experience in database structures, and standard query and reporting tools; or any combination of education and experience which would provide an equivalent background.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive' 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: PS70721-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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

The Performance Quality Audit III is responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.

Primary duties may include, but are not limited to:

• Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders. Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.

• Tracks and trends audit results, providing feedback to management.

• Identifies and reports on systemic issues which create ongoing quality concerns.

• Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management with information requested.

• Produces other ad hoc reports as requested by internal and external clients.

• Provides training, mentoring and support to quality staff.

• Associates at this level function as subject matter experts, conducting routine to complex audits, generally related to multiple functions on multiple systems platform for multiple lines of business.

• Works proactively and independently including facilitation of calibration sessions with clients and/or teams.

Qualifications

Primary requirements:

• Requires high school diploma or equivalent (GED)

• Minimum 5 years experience

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

• WGS claims adjustment experience required

• Pre-Pay and/or Overpayment knowledge required

Preferred requirements:

• Working knowledge of insurance industry and medical terminology

• In-depth knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines strongly preferred.

• Ability to acquire and perform progressively more complex skills and tasks in a production environment 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: PS71009

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 supporting the end-to-end lifecycle of moderate complexity, often multi-channel, marketing campaigns by providing project management and/or executional support and may provide direction to a Project Coordinator. Primary duties may include, but are not limited to: - Supports marketing strategies by ensuring projects are delivered on time, on scope and on budget. - Provides strategic counsel and executes project management best practices and tactics that align with brand objectives/goals. - Supports the strategy and leads planning for assigned brands and phases across the entire consumer lifecycle. - Develops functional specifications and requirement documents. - Develops and manages project timelines. - Collaborates with a large group of stakeholders across - Marketing to ensure functional specifications and requirement documents are met.

Qualifications

- Requires a BA/BS degree and a minimum of 4 years of related experience; or any combination of education and experience, which would provide an equivalent background.

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.

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: PS70687

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Job Title: Innovation Director - New Ventures Location: Palo Alto, CA; Remote work location is available for this role

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. As a Director in Anthem's Digital Incubator (ADI), you will: (1) source high-potential early-stage health tech startups, (2) support them through core incubation activities, including business model and product development, go-to-market strategy and generating proof of concepts that can be tested to demonstrate value and (3) consider early-stage investment opportunities in ADI portfolio companies. This role will champion the highest value initiatives, developing and presenting the holistic business case around them, and ensure that they are placed with the right team to be implemented and scaled to create measurable value for the business.

How you will make an impact:

• Source, analyze and structure investments in high-potential early-stage health tech startups

• Support start-ups through core incubation activities, including business model and product development, go-to-market strategy and generating proof of concepts that can be tested to demonstrate value

• Build relationships with key business unit leaders to understand how ADI can support and help solve problems that address their core business needs

• Develop partnerships with our incubation partners and own key program deliverables such as building pilot proposals and design, go-to-market strategy, product roadmap and more

• Work across our Innovation platform to ensure business use case is planned out from inception to scale phase

• Provide thought leadership to leaders across Digital and the Enterprise

Qualifications

Minimum Requirements:

• BA/BS degree in Information Technology, Computer Science or related field of study and 15 years' experience in information technology, healthcare, consulting, and/or consumer technologies; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Experience working within the healthcare start-ups ecosystem in venture capital or at an incubator/accelerator.

• Top-tier consulting experience (e.g., Bain, McKinsey, BCG) or corporate strategy experience within a healthcare company

• Previous experience working directly with or for healthcare payers

• Ability to effectively source and perform due diligence - including financial analysis - on early-stage health tech companies

• Knowledge of the healthcare start-up ecosystem, including key market trends and business models

• Ability to employ a hypothesis-driven approach to tackle complex problems by leveraging the appropriate methodologies, exuding excellent business judgment and taking a practical, common-sense approach to getting things done

• Strategic mindset and the ability to see and act within the bigger picture while connecting dots and finding opportunities for collaboration

• Skillful at building consensus and making thoughtful, data-driven recommendations

• Excellent business judgment and a practical, common-sense approach to getting things done

• Masterful cross-functional communication to ensure all technical and non-technical stakeholders can collaborate effectively and stay engaged throughout the lifecycle of a project

• Ability to insightfully examine the status quo, analyze opportunities for improvement, creatively generate solutions, and demonstrate the grit to realize the change

• Adept at managing timelines, presentation building and delivery and effectively collaborating to win the respect of your peers and stakeholders.

  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: PS71054-US

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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

The Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Primary duties may include, but are not limited to:

• Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.

• Determines and calculates amount of overpayments and processes refunds.

• Researches voluntary refunds for accuracy.

• Requires accurate balancing of all accounts.

• Responsible for more routine issues. May work with internal staff from other departments to ensure customer satisfaction.

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

Qualifications

Primary requirements:

• Requires a H.S. diploma

• Minimum of 1 year of claims processing and/or customer service experience

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

• System knowledge of COR (Cash Ops), WGS Adjustment experience required

Preferred reequirements:

• AA/AS 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: PS71015

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

Primary duties may include, but are not limited to:

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

• Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies.

• Works closely with staff from other departments on a regular basis to ensure customer satisfaction.

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

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

• Researches voluntary refunds for accuracy.

• Requires accurate balancing of all accounts.

Qualifications

Primary requirements:

• Requires a H.S. diploma

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

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

• System knowledge of WGS claims adjustments required,

Preferred requirements:

• AA/AS or higher level degree preferred.

• COR and Cash Ops knowledge 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: PS71010

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?

he Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Primary duties may include, but are not limited to:

• Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.

• Determines and calculates amount of overpayments and processes refunds.

• Researches voluntary refunds for accuracy.

• Requires accurate balancing of all accounts.

• Responsible for more routine issues.

• May work with internal staff from other departments to ensure customer satisfaction.

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

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

Primary duties may include, but are not limited to:

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

• Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies.

• Works closely with staff from other departments on a regular basis to ensure customer satisfaction.

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

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

• Researches voluntary refunds for accuracy.

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

Primary duties may include, but are not limited to:

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

• Interacts with staff and management from other departments on a regular basis to ensure customer satisfaction.

• May work with recovery and collection vendors to validate overpayments, validate vendor invoices and provide feedback to modify queries when needed.

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

• Handles complex case research and resolution.

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

• May review and monitor associates work for quality standards.

• May review department policy and procedure manuals for accuracy and works to ensure procedures and polices are accurate and complete.

• Assists in special projects to find and prevent overpayments and to identify process improvements.

• Completes special projects as assigned with minimal supervision.

• Researches voluntary refunds for accuracy.

• Requires accurate balancing of all accounts.

Qualifications

Financial Operations Recovery Specialist I primary requirements:

• Requires a H.S. diploma

• Minimum of 1 year of claims processing and/or customer service experience

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

Financial Operations Recovery Specialist I preferred requirements:

• AA/AS preferred.

Financial Operations Recovery Specialist II primary requirements:

• Requires a H.S. diploma

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

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

Financial Operations Recovery Specialist II preferred requirements:

• AA/AS or higher level degree preferred.

Financial Operations Recovery Specialist III primary requirements:

• Requires a H.S. diploma

• Minimum of 4 years of claims processing and/or customer service experience

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

Financial Operations Recovery Specialist III preferred requirements:

• AA/AS or higher level degree preferred.

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

  REQNUMBER: PS71003

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Job Title: ASO Contract Admin Consultant

Location: Anthem Hub Locations

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 ASO Contract Admin Consultant is responsible for providing triage support for ASO contracts and other alternately funded type agreements, assisting in ASO contract negotiations, and drafting ASO, stop loss and other alternately funded agreements.

Primary duties may include, but are not limited to:

• Reviews, researches, and quantifies the impact to contract/agreement modifications.

• Utilizes contract language expertise to draft or recommend customized alternative language provisions.

• Drafts new and renewing self-funded agreements.

• Assists in contract negotiations.

• Resolves questions pertaining to contracts with sales.

• Triages alternative language contract issues as appropriate.

• Reviews and maintains working knowledge of related laws and regulations and supports compliance efforts.

• May serve as subject matter expert in understanding business needs and identifying business requirements.

• Serves as security expert for contract database authorization.

• Researches and troubleshoots database issues for resolution or escalation to vendor.

• Conducts research and analysis for enhancements or new projects related to the contract database.

• Supports projects related to legislative and business requirements impacting ASO agreements.

• Assists in monitoring and evaluating workflow processes in order to identify and recommend process improvements.

• Mentors new team members on contract administration processes.

Qualifications

Minimum Qualifications:

• Requires a BA/BS and a minimum of 6 years of healthcare experience, including contract language development, negotiation, or administration; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Strong research and analytical skills and the ability to translate project and process management tools and processes to contract development activity strongly preferred.

• Contract negotiation skills preferred.

• Problem solving and organization skills highly preferred.

• Project management experience is a plus.

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

  REQNUMBER: PS71159

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 IN, VA, OH, GA, IL or VA but will consider other locations.

Responsible for programming on specific application subsets of the company's application portfolio, participating in all phases of the development and maintenance life cycle, typically for an assigned business unit, client program, or corporate department and utilizing various customer technology platforms.

Primary duties may include, but are not limited to:

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

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

• Develops and owns list of final enhancements.

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

• Performs technical design reviews and code reviews.

• Ensures unit test is completed and meets the test plan requirements, system testing is completed and system is implemented according to plan.

• Assesses current status and supports data information planning.

• Coordinates on-call support and ensures effective monitoring of system.

• Maintains technical development environment.

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

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

• Supports vendor evaluation.

Qualifications

Minimum Requirements:

• BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 5 years related experience; multi dimensional platform experience; expert level experience with business and technical applications, or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Core Java

• PL/SQL and Stored Procedures

• Oracle Webcenter Portal 12c

• Oracle Webcenter content 12c

• Oracle ADF Framework 12c

• Oracle Weblogic Server 12c

• Groovy Scripts

• Java/J2EE REST Services

• Spring Boot & Hibernate

• Oracle Database 12c

• Groovy , Perl Scripts and J2EE

• Elastic Search

• Experience leading people, small projects and provide troubleshooting support strongly preferred

• Multi database and/or multi language 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: PS71228

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?

*Please note: This position may be filled at either the Digital Marketing Project Manager or Digital Marketing Project Coordinator. The Hiring Manager will determine level based upon the selected applicant's skillset relative to the qualifications listed for this position. *

Digital Marketing Project Manager

In this role, you will be responsible for supporting the end-to-end lifecycle of moderate complexity, often multi-channel, marketing campaigns by providing project management and/or execution support and may provide direction to a Project Coordinator.

Primary duties may include, but are not limited to: - Supports marketing strategies by ensuring projects are delivered on time, on the scope, and on budget. - Provides strategic counsel and executes project management best practices and tactics that align with brand objectives/goals. - Supports the strategy and leads planning for assigned brands and phases across the entire consumer lifecycle. - Develops functional specifications and requirement documents. - Develops and manages project timelines. - Collaborates with a large group of stakeholders across Marketing to ensure functional specifications and requirement documents are met.

Marketing Project Coordinator In this role you will be responsible for supporting the end-to-end lifecycle of low complexity, often email only, marketing campaigns by providing project management and/or execution support under the direction of a lead.

Primary duties may include, but are not limited to: - Supports marketing strategies by helping to ensure projects are delivered on time, on scope and on budget. - Executes project management best practices and tactics that align with brand objectives/goals. - Supports the strategy and coordinates planning for assigned brands and phases across the entire consumer lifecycle. - Develops functional specifications and requirement documents. - Develops and manages project timelines. Collaborates with a small group of stakeholders across Marketing to ensure functional specifications and requirement documents are met.

Qualifications

Digital Marketing Project Manager Qualifications - BA/BS degree and a minimum of 4 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Digital Marketing Project Coordinator Qualifications - Requires a BA/BS degree and a minimum of 2 years of related 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: PS70692

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 Digital Content Strategist is responsible for the planning and delivery of content strategy deliverables for primarily single channels business units on the front end, including but not limited to content story architecture, content migration crosswalks, and content contribution interface needs to enhance the authoring experience.

Primary duties may include, but are not limited to: - Works with business partners to understand their objectives and come up with optimized content solutions leveraging business goals, user needs, relevant data points, and Content Management Systems (CMS). - Executes content strategy deliverables, which may include writing original content, coordinating and editing content authored by others and contributing content to the CMS. - Advises internal business partners on best-in-class digital content writing, managing Omni channel content development. - Establishes content strategy recommendations across multiple digital properties. - Work with UX/Design to develop new design elements. - Writes stories / requirements to support the optimization of the content experience and/or build out of a content management platform supporting multi-channel digital content distribution. - Contributes to a core centers of excellence for digital content at Anthem.

Qualifications

- BA/BS degree in a related field and a minimum of 5 years of experience in governance of UX-focused enterprise web content strategy and management in complex regulated industries; or any combination of education and experience, which would provide an equivalent background. Preferred Qualifications - Master's degree.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

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

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

REQNUMBER: PS71134

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Title: Nurse Demand Management I,II, SR (Job Family) Location: Must be in Eastern Time Zone

NurseLine: 24/7 Inbound Telephone Triage level will be determined by Hiring Manager based on experience, skills and education. Hours/Shift: Associate will be working around Eastern time zone - 24 hour department; multiple shifts available $3,000 Sign On Bonus Please Note: Associates in this job are paid hourly and are eligible for overtime.

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

The Nurse Demand Management I/II/ and Senior are responsible for telephone triage to assess complex caller's needs and provide relevant health information to assist caller in making healthcare decisions. Also serves as a resource to lower-level medical call nurses.

How you will make an impact: - Serves as a resource to lower-level medical call nurses. - Establishes and maintains supportive relationships with callers and their families. - Performs professional assessment of caller's needs with accurate, concise documentation. - Conducts thorough symptom assessment of caller's situation using established criteria and protocol. - Coordinates with case management and/or staff physicians. - Utilizes established software, written materials, on-line resources and nursing background to provide callers with appropriate medical information. - Provides caller with appropriate community resources. Conducts research and problem-solving activities for more complex situations. - May be assigned to work special projects relevant to medical call or general medical management policies, practices and procedures.

Qualifications

Nurse Demand Management I Minimum Qualifications: - Requires an AS/BS in nursing; 2 years of acute clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license in applicable state(s) required.

Nurse Demand Management II Minimum Qualifications: - Requires an AS/BS in nursing; 3 years of acute clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license in applicable state(s) required.

Nurse Demand Management Sr Minimum Qualifications: - Requires AS in nursing and minimum of 5 years of acute clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and Experiences for all levels: - BSN and previous triage experience preferred. - ER + Critical care experience preferred - RN 2-3 years' experience preferred - Med Surge 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: PS70640-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?

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

Location: Work@Home TX, VA, CT, GA, NY, MO, FL, NC, SC, TN

Hours: Monday - Friday between the hours of 8:30am to 8:00pm EST

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.

Focus: Prevention of 30 day readmissions (inpatient) and decrease frequent ER visits for non-urgent symptoms.

How you will make an impact

Responsible for performing care management with focus on preadmission counselling, inpatient advocacy and post discharge management of member within the scope of licensure for members with complex and chronic care needs. Required skill set to include case management best practices in assessment of member, discharge planning, development of goals, implementation, coordination of services and evaluation of care plans designed to optimize member health care across the care continuum. Strong knowledge base of diseases and critical thinking acumen. Utilization Management experience preferred.

Primary duties may include, but are not limited to:

• Ensure and coordinates member access to internal and external 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.

• 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.

Qualifications

Nurse Case Mgr I

Minimum Requirements:

• 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 the state you reside.

• Multistate licensure is required if this individual is providing services in multiple states.

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

• Minimum 2 years' experience in acute care setting.

  Preferred Capabilities, Skills and Experiences:

• Ability to work independently with minimal oversight post orientation.

• Certification as a Case Manager.

• 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:

• 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 the state you reside.

• Multistate licensure is required if this individual is providing services in multiple states.

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

• Minimum 2 years' experience in acute care setting.

  Preferred Capabilities, Skills and Experiences:

• Ability to work independently with minimal oversight post orientation preferred.

• Certification as a Case Manager.

• 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: PS71177-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 Financial Operations Recovery Specialist I is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments.

Primary duties may include, but are not limited to:

• Reviews and validates paid claims for overpayments using various techniques including system-based queries, specialized reporting, or other research.

• Determines and calculates amount of overpayments and processes refunds.

• Researches voluntary refunds for accuracy.

• Requires accurate balancing of all accounts.

• Responsible for more routine issues.

• May work with internal staff from other departments to ensure customer satisfaction.

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

Qualifications

Primary requirements:

• Requires a H.S. diploma

• Minimum of 1 year of claims processing and/or customer service experience

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

Preferred requirements:

• AA/AS 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: PS71049

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Title: Nurse Demand Management I,II, SR (Job Family) Location: Must be in Eastern Time Zone

NurseLine: 24/7 Inbound Telephone Triage level will be determined by Hiring Manager based on experience, skills and education. Hours/Shift: Associate will be working around Eastern time zone - 24 hour department; multiple shifts available $3,000 Sign On Bonus Please Note: Associates in this job are paid hourly and are eligible for overtime.

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

The Nurse Demand Management I/II/ and Senior are responsible for telephone triage to assess complex caller's needs and provide relevant health information to assist caller in making healthcare decisions. Also serves as a resource to lower-level medical call nurses.

How you will make an impact: - Serves as a resource to lower-level medical call nurses. - Establishes and maintains supportive relationships with callers and their families. - Performs professional assessment of caller's needs with accurate, concise documentation. - Conducts thorough symptom assessment of caller's situation using established criteria and protocol. - Coordinates with case management and/or staff physicians. - Utilizes established software, written materials, on-line resources and nursing background to provide callers with appropriate medical information. - Provides caller with appropriate community resources. Conducts research and problem-solving activities for more complex situations. - May be assigned to work special projects relevant to medical call or general medical management policies, practices and procedures.

Qualifications

Nurse Demand Management I Minimum Qualifications: - Requires an AS/BS in nursing; 2 years of acute clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license in applicable state(s) required.

Nurse Demand Management II Minimum Qualifications: - Requires an AS/BS in nursing; 3 years of acute clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license in applicable state(s) required.

Nurse Demand Management Sr Minimum Qualifications: - Requires AS in nursing and minimum of 5 years of acute clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and Experiences for all levels: - BSN and previous triage experience preferred. - ER + Critical care experience preferred - RN 2-3 years' experience preferred - Med Surge 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: PS70640

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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

Location(s): VA, GA, OH, IL, IN and will consider other locations as well.

This position is listed as a job family - Engineer Sr, Engineer III, Engineer II, Engineer I

Responsible for delivery of end-to-end application, system development and maintenance on complex multi technology platforms within assigned client group, business unit or corporate department and utilizing various customer technology platforms. Primary duties may include but are not limited to:

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

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

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

• Research and may propose new technologies.

• Develops and owns list of final enhancements.

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

• Performs technical design reviews and code reviews.

• May own technical testing to ensure unit test is completed and meets the test plan requirements, system testing is completed, and system is implemented according to plan.

• Assesses status and supports data information planning.

• Coordinates on-call support and ensures effective monitoring of system.

• Maintains technical development environment.

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

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

• Provides technical guidance, and mentoring.

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

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

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

• Supports vendor evaluation.

Qualifications

Minimum Requirements:

• Engineer Sr requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 5 years related experience; or any combination of education and experience, which would provide an equivalent background.

• Engineer III requires a BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 3 years experience; or any combination of education and experience, which would provide an equivalent background.

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

• Engineer I requires a BA/BS degree in Information Technology, Computer Science or related field of study. Requires experience working on one platform, one database and/or one system language.

Preferred Qualificiations:

• Multi-dimensional platform experience.

• Expert-level experience with business and technical applications, or any combination of education and experience, which would provide an equivalent background.

• Multi-database and/or multi-language strongly preferred.

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

• Oracle, SQL, SSRS, SSIS.

• Informatica (desired).

• Health care and FACETS experience (desired).

• .Net experience is a plus.

• DevOps experience - (extra Plus).

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

  REQNUMBER: PS68863

Job Detail

• Company:
  Anthem, Inc.

Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

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?

*Please note: This position may be filled at either the Business Development Consult or Business Development Manager or Business Development Specialist Senior. The Hiring Manager will determine the level based upon the selected applicant's skillset relative to the qualifications listed for this position. *

Business Development Consult

You will be responsible for identifying and developing new business growth initiatives by maximizing strategies and growth opportunities in targeted markets identified through the annual planning process.

Primary duties may include, but are not limited to: - Monitors and analyzes product lines to help determine optimal strategy. - Provides research, analysis and recommendations on the external environment as part of the development of strategic plans for the business unit. - Analyzes major competitor strategies. Identifies and monitors changing patterns of competition and recommends responses. - Acquires and maintains data/information on market, industry, economic, consumer and competitive conditions and trends pertaining to health insurance/managed care and related services. - Ability to travel may be required.

Business Development Manager You will be responsible for leading the development of new business plans/strategies for both new and existing businesses. Primary duties may include, but are not limited to: - Leads the analysis of current and projected product lines to determine optimal business strategy. - Oversees research, analysis and the development of recommendations on the external environment as part of the development of strategic business plans. - Analyzes major competitor strategies. Identifies and monitors changing patterns of competition and recommends response. - Acquires and maintains data/information on market, industry, economic, consumer and competitive conditions and trends pertaining to health insurance/managed care and related services. - Consolidates data, analyses and recommendations into concise business plans. - Develops and implements project plans and oversees project resources. - Leads the activities of lower-level staff performing related functions.

Business Development Specialist Senior You will be responsible for developing new business areas which complement existing offerings.

Primary duties may include, but are not limited to: - Develops business plans and formulate strategies for both new and existing businesses. - Monitors and analyzes product lines to help determine optimal strategy. - Provides research, analysis and recommendations on the external environment as part of the development of strategic plans for the business unit. - Analyzes major competitor strategies. - Identifies and monitors changing patterns of competition and recommends response. - Acquires and maintains data/information on market, industry, economic, consumer and competitive conditions and trends pertaining to health insurance/managed care and related services. - May lead or coordinate the activities of lower level staff performing related functions.

Qualifications

Business Development Consult Qualifications - BA/BS related degree and a minimum of 5 years of healthcare-related experience including at least 3 years of business development experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications - MS/MBA is preferred.

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

Preferred Qualifications - Master's degree preferred. Business Development Specialist Senior Qualifications - Requires a BA/BS degree and a minimum of 2 years of business development 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: PS71074-Virginia

Job Detail

• Company:
  Anthem, Inc.