Anthem In. Case Management Jobs

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Anthem, Inc Medical Management Specialist I - Louisville, KY- PS23655 in Louisville, Kentucky

Medical Management Specialist I - Louisville, KY- PS23655

Location: Louisville, Kentucky, United States

Requisition #: PS23655

Post Date: Sep 09, 2019

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating

greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Medical Management Specialist I

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.

  • High School diploma or GED

  • 1 year of experience with an understanding of managed care or Medicaid/Medicare

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

  • Extremely focused and detail oriented.

  • Excellent written and oral communication skills

  • Able to work Monday-Friday 8:30 AM - 5:30 PM

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran