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Medical Management Specialist ...

Monster
 
 
 
 

Job Summary

Company
Anthem
Location
Louisville, KY
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS4777

Medical Management Specialist I - Louisville (PS4777)

About the Job

Description
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.
  • The hours for this opening are M-F 9-6
Qualifications

Qualifications:

  • 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 skill
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 antheminc.com/careers. EOE. M/F/Disability/Veteran
 

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