Medical Mgmt Specialist I PS36153

Local Jobs Anthem
  • United States, Tampa, FL 33607 View on Map
  • Post Date: June 18, 2020
  • Apply Before : July 18, 2020
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Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time


Your Talent. Our Vision
. At Simply Healthcare, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. We are a Florida licensed health maintenance organization that serves individuals enrolled in Medicaid and/or Medicare programs, 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.

Onsite office: 4200 West Cypress Street, Tampa, FL

This is an exceptional opportunity to do innovative work that means more to you and those we serve.

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.


**Must reside in the Tampa, FL area.**

Qualifications

  • Requires a high school diploma.
  • 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.
  • Data entry experience is preferred.
  • Associates degree or higher is preferred.
  • Utilization Management experience (authorization entry) is preferred.
  • Required hours for this position would be 8 am – 5 pm ET, Monday through Friday.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.

 

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