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Medical
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PS23302 Requisition #
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.

Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. 
Performs duties telephonically or on-site such as at hospitals for discharge planning. 
Primary duties may include, but are not limited to: 
Ensures member access to services appropriate to their health needs. 
Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. 
Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. 
Coordinates internal and external resources to meet identified needs. 
Monitors and evaluates effectiveness of the care management plan and modifies as necessary. 
Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. 
Negotiates rates of reimbursement, as applicable. 
Assists in problem solving with providers, claims or service issues. 

Requires:
  • BA/BS in a health-related field; 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
  • Broad range of experience with Diabetes, Cardiac Care, COPD and obesity a plus
  • Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states. 
  • Certification as a Case Manager is preferred.
  • Experience with HIV and Hepatitis C preferred. 

  • At least 3 – 5 years’ experience in Pediatric and developmental disabilities and Autism.




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.

AnEqualOpportunityEmployer/Disability/Veteran

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Transformation Office

You’re driven, client-focused, collaborative, strategic, and goal-oriented. You thrive on making an impact by implementing sustainable improvements and leading business transformations.

To remain leading-edge, we employ a highly skilled, versatile, and diverse internal management consulting team, our Transformation Office. This team partners with commercial business and shared service leaders to understand, improve and objectively solve complex, cross cutting challenges; execute upon strategy and implement high value initiatives; and build new business and cultural capabilities to achieve Anthem, Inc.’s vision, values, and objectives.

Highlights

The Transformation Office hosts an exciting internal consultant internship that provides a unique, hands-on experience within our internal management consulting team. As part of this summer internship, you will:

  • Help us address pivotal business and organizational opportunities
  • Contribute to the achievement of both sustainable improvements and transformational change
  • Establish relationships at the executive level across the Anthem, Inc. organization
  • Lead an initiative to enhance effectiveness and profitability

Qualification for Program

Interns must have completed two years of college, be enrolled in an accredited university or college and have a 3.0 or above grade point average. Additionally, intern candidates will typically have:

  • BA/BS major in one of the following fields: Business Administration, Finance, Communications, Healthcare Management, Healthcare Administration, Public Health, Marketing, Engineering, or Technology
  • Student leadership experience (preferred)
  • Excellent communication
  • Analytical and financial acumen
  • Project management skills (including time management, risk management, etc.)
  • Leadership skills

Interns must have U.S. work authorization, and be enrolled and in good standing in a full-time, accredited Master’s program. Additionally, intern candidates will typically have:

  • Master’s degree in business, healthcare or public affairs related field and 5-7 years’ experience in management consulting, change management, large scale project management and/or process improvement leadership (or equivalent combination of relevant education and experience)
  • Strong business acumen
  • Excellent communication, cost-benefit analysis, situational leadership and execution skills
  • Excellent computer skills, demonstrating fluency with all key packages
  • Advanced decision making through data driven analysis
  • Ability to provide vision, direction and leadership to high-performing teams, on high-priority, medium-sized projects
  • Strong relationship management skills with professionals at all levels within the organization
  • Cross-functional perspective and quick, continuous learning style
  • Ability to work effectively in a virtual team environment
  • Ability to travel up to 25-50% of the time (varies based on project assignment)

Additionally, the following are highly preferred, but not required:

  • Healthcare experience
  • Six Sigma Black Belt Certification or Lean Masters certification
  • Project Management (PMP) certification

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