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Medical
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PS18000 Requisition #

AIM Specialty Health (AIM), a proud member of the Anthem family of companies, is a national leader in specialty benefit management.  Through an innovative technology platform and steadfast commitment to excellent customer service, AIM promotes the appropriate, safe and cost effective use of clinical services including: musculoskeletal, radiology, cardiology, oncology, specialty drugs, and sleep medicine.


Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. 
  • Responsible for the review of medical records to determine if requests for therapy services (physical therapy, occupational therapy, and/or speech-language pathology) were medically necessary and filed appropriately.
  • Primary duties may include, but are not limited to: 
  • Applies professional therapy, government regulation, and medical policy knowledge to medical review, and makes determinations for authorization requests, meeting all contract requirements, processes and operational unit goals to ensure customer satisfaction. 
  • Documents findings, develops analyses, and submits reports to the appropriate departments in accordance with government regulations and requirements. 
  • Researches and obtains additional data, consults with clinical reviewers and medical directors, when necessary. 
  • Acts as a resource for internal and external customers. 
  • May participate in intradepartmental teams, projects, and initiatives. 
  • Maintains quality and productivity standards and ensures reviews are conducted within required time frames. 

Requirements:
  • A graduate of a college level program in physical therapy, occupational therapy, or speech language pathology or an accredited two year program for a Physical Therapist Assistant, Occupational Therapist Assistant, or Speech Language Pathologist Assistant; 1 year of clinical experience; or any combination of education and experience, which would provide an equivalent background. 
  • 3 WEEKS of on mandatory site training in Glendale CA and must have residency in the state of CA
  • Certification and/or licensure appropriate to field of specialty as required. 
  • For URAC accredited areas the following applies: 
  • Requires current, active, unrestricted license in occupational, speech, or physical therapy to practice as a health professional within the scope of practice in applicable state(s) of CALIFORNIA, United States. Current, active, unrestricted license or certification as a physical therapist assistant, occupational therapist assistant, or speech language pathologist assistant in applicable state of CALIFORNIA United States. 
  • Unless expressly allowed by state or federal law or regulation, are located in a state or territory of the United States when conducting a peer clinical review. 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 2018 Diversity Inc 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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You have to be at least 18 years of age (unless part of an approved/sponsored program) and currently enrolled in an accredited US college or university. For actuarial students, sitting for or having at least one exam completed by the time your interview is an advantage.

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