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Investigator Sr - PS 19501 (Any Anthem location or remote)

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Fraud
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PS19501 Requisition #
Thanks for your interest in the Investigator Sr - PS 19501 (Any Anthem location or remote) position. Unfortunately this position has been closed but you can search our 970 open jobs by clicking here.
  • Requires BA/BS degree 5+ years related experience in healthcare insurance and healthcare insurance investigation, law enforcement or any combination of education and experience which would provide an equivalent background. 
  • Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job related designation preferred.  
  • Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred.
  • Experience using a case tracking system. 
  • Strong understanding of vendor policies and procedures preferred.
 
We currently have opening for this position which may be located in any Anthem location or remote.  
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. 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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Metrics & Data

Leverage your talents to make a difference in people's lives, by providing innovative, data-driven solutions that can measure and improve consumer's health.

Anthem metrics and data associates focus on creating innovative, data-driven solutions that can measure and track progress in our members’ health. Collaborate with internal and external experts to develop metrics-supported strategies for improving measurements and processes.

Enable physicians and hospitals to improve care with valuable information that improves care quality and affordability. Join us and help provide tools to help consumers make better decisions, as we create a simpler, more affordable, more accesible healthcare system.

Metrics and data associates at Anthem:

  • Develop statistical models and functional means for measuring the quality of health care members receive annually
  • Provide members with useful, powerful tools for self-evaluation and tracking of health issues and risk factors
  • Show initiative and make key decisions with the potential to dramatically influence patient outcomes and positively impact peoples' lives
  • Create thoughtful solutions that engage and empower members to make more informed decisions about their health and health care
  • Serve as a catalyst to improve the essential relationship between patient and health care provider
  • Leverage metrics and data to deliver resources that help overcome traditional coverage barriers such as education, literacy and language

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