Anthem In. Case Management Jobs

Job Information

Anthem, Inc. Medical Management Specialist I in Dallas, Texas

Description

SHIFT: Day Job

SCHEDULE: Full-time

Responsibilities:

Responsible for providing non-clinical support to the Medical Management and/or Operations areas.

Primary duties may include, but are not limited to:

  • Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).

  • Provides information regarding network providers or general program information when requested.

  • May assist with complex cases.

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

  • Maintains and updates tracking databases.

  • Prepares reports and documents all actions.

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

Qualifications

Minimum Requirements:

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

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

Preferred Qualifications:

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

    REQNUMBER: PS57412-Dallas-Dallas

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