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Medical
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PS13930 Requisition #
Thanks for your interest in the Nurse Medical Mgmt I/II Remote - (PS13930) position. Unfortunately this position has been closed but you can search our 726 open jobs by clicking here.


Nurse Medical Management I

Requires:

  

  • Current active unrestricted RN license practice in state of residence.
  • 2 years clinical RN experience.
  • 2 years of experience with medical review and/or utilization management required.
  • Managed Care experience preferred.
  • Experience working with Microsoft Office (Outlook and Word).
  • Experience using electronic documentation and using multiple computer screens.
  • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • Claims research preferred 
Nurse Medical Management II
Requires: 
  • Current active unresctirced RN license in state of residence.
  • 3-5 Medical review and or utilization management required.
  • Managed Care experience preferred. 
  • Participation in the American Association of Managed Care Nurses preferred.
  • Experience working with Microsoft Office (Outlook and Word).
  • Experience using electronic documentation and using multiple computer screens
  • Must have knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products.
  • Prior managed care experience strongly preferred.
  • Utilization and medical review background
  • Claims research preferred 
  • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills

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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Health Care Analytics

The Health Care Analytics (HCA) team focuses on transforming the way data is used within the health care industry. They provide strategic analysis that impacts business decisions, improves efficiency and drives innovation.

As we expand our technology and analytics capabilities, we are searching for associates that have a passion for analytics and the drive to pave the way in a growing industry.

Career opportunities are available in the following areas:

  • Strategy and planning: Ensures strategic alignment between HCA projects and the organization's broader goals. Also integrates analytics strategy into the execution process, including program management, project controls, communications and vendor oversight.
  • Operations: This department houses the HCA shared-services functions including project financial controls and estimations, demand management, user acceptance testing, and coordination and release management.
  • Customer management analytics: Provides accurate, timely and reliable delivery of client reports, which include data analyses, insights and other information that demonstrates Anthem’s value as a business partner.
  • Financial management analytics: Works closely with HCA leaders and other Anthem management to provide support to the finance and accounting teams through financial reporting systems.
  • Member management analytics: This team is responsible for the risk adjustment program and analytics, the member management program, predictive analytics and member management analytic products management.
  • Provider management analytics: Manages Anthem’s unit cost trend, provider contract modeling, network profiling, payment innovation analytic solutions, and other analytics that enable provider collaboration strategies.
  • Research, development and transformational analytics: Works with senior leaders to manage implementations, new product development and provides acquisition support.

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