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RN Medical Policy Coordinator ...


Job Summary

Chicago, IL
Other/Not Classified
Job Type
Full Time
Career Level
Experienced (Non-Manager)
Job Reference Code

RN Medical Policy Coordinator - AIM Chicago - PS3652

About the Job

This position is located at AIM's corporate headquarters in Chicago IL (near O'Hare Airport).

Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

Responsible for developing and maintaining a systematic process to support implementation and maintenance of solution medical policies and guidelines and integral part of clinical knowledge team.

Primary duties may include, but are not limited to:

  • Works with Medical Directors to identify and analyze clinical medical policies and guidelines
  • Supports maintenance of clinical content/ policy updates
  • Tracks and logs clinical content programs.
  • Able to work with clinical tools used to support the internal access to the clinical content
  • Investigates new technologies/associated policies; and serves as a backup to the Medical Policy Research Specialist.
  • Provide subject matter expertise to assist with integration of clinical content and related processes
  • May assist in development of training materials for clinical operations
The qualified candidate will have:
  • Requires a BA/BS in a related field; 5 years of related experience; or any combination of education and experience, which would provide an equivalent background.
  • BSN preferred or any strong clinician with Medical Policy experience considered
  • Requires knowledge of medical policy, emerging technology and analysis of emerging evidence.
  • Experience in the use of CMS NCD's and LCD's
  • Familiarity with Medicare coverage determination, Medicaid and CPT codes is preferred.
  • Detail minded and able to meet policy implementation and project deadlines.
  • Familiarity with Medical Terminology
  • Must have knowledge and have used with Microsoft Word, Excel, PowerPoint and Visio
  • Ability to manage multiple projects simultaneously
  • Team player
  • Listens well and influences decisions through written and verbal communication
  • Comply with corporate and departmental policies and procedures
  • Ability to adhere to AIM's code of conduct
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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