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Nurse Reviewer Associate or Nurse Reviewer I

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Medical
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PS27114 Requisition #
Thanks for your interest in the Nurse Reviewer Associate or Nurse Reviewer I position. Unfortunately this position has been closed but you can search our 1,049 open jobs by clicking here.

Nurse Reviewer I & Nurse Reviewer Associate SHARED qualifications:

  • Registered Nurse with a current, valid unrestricted license in the State of California
  • Candidates must have good computer skills and solid typing speed and accuracy
  • Knowledge of managed healthcare programs - HMO, PPO, and POS are preferred
  • Familiarity with Utilization Management Guidelines preferred
  • Familiarity with ICD-9 and CPT 4 coding preferred 

Nurse Reviewer I specific qualifications:

  • 3 + years recent clinical nursing experience in an ambulatory or hospital setting
  • Previous utilization and/or quality management and/or call center experience is helpful

 

Nurse Reviewer Associate specific qualifications:

 Graduate of an accredited school of nursing

  • Any experience in clinical nursing experience is a plus
  • Customer service experience is preferred
  • Quality management and/or call center experience is a plus

AIM- A Leading Employer of Choice, Benefits at a Glance

 

Along with a dynamic, entrepreneurial work environment, AIM offers competitive compensation, a generous benefits package and the opportunities for career progression you'd expect from an industry leader.

 

These benefits include:

            An array of Health, Dental and Vision Care Insurance plans

  • Term Life Insurance
  • Short- and Long-term Disability Insurance
  • 401(k) Employee Savings Plan with company match
  • Employee Stock Purchase Plan
  • Paid Time Off
  • Tuition Reimbursement
  • Tax-advantaged health care and dependent flexible spending plans
  • Health club reimbursement allowance
  • Licensure reimbursement for medical professionals

 

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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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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