Job description
JP#43306
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
Required
- 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.
Additional Details
- Work Hours
- Monday - Friday - 8a-5p Central Standard Time
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