Anthem Inc. Veterans Jobs

Job Information

Anthem, Inc. Medicare Process Improvement Consultant in San Jose, California

Description

SHIFT: Day Job

SCHEDULE: Full-time

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 care companies and a Fortune Top 50 Company.

Must be within 50 miles of any Anthem office with Wallingford, CT; Mason, OH or Indinapolis, IN preferred

Responsible for generating process improvements that bring about measurable improvement in quality and/or efficiency. Contributes to achieve department's objectives by serving as key contact for researching and implementing solutions and tools for new systems and other key operational improvements, provide guidance to leads, operations experts, associates, and/or managers on process improvement issues.

Primary duties may include, but are not limited to:

Represents the department on process improvement teams, special projects and implementation of new technology.

Lead role in coordinating annual review/revision of procedures.

Coordinates with the trainer when new processes or procedures are implemented.

Communicates process information and facilitates workgroups to ensure accurate and consistent workload reporting.

Review /analyze monthly workload reports to ensure goals are on-target (timeliness, backlog) across all operational sites.

Identify areas of concern & implement corrective plans if necessary.

Uses reports and production statistics to represent unit(s) in departmental process improvement and system changes and provides specialized input on reports to management.

Qualifications

Requires a BA/BS degree in a related field

5-8 years of related experience

Medicare experience required

Medicare Grievance & Appeals expereince highly preferred

Or any combination of education and experience, which would provide an equivalent background.

RN, Certified Project Manager or Certified Professional Coder preferred.

Previous experience in high-volume operations (Medical Review, Appeals, Claims, Customer Service) required.

Demonstrate ability to analyze existing and potential workflows, processes, supporting systems, and procedures and identifying improvements required.

Excellent oral, written and interpersonal communication skills required.

Strong analytical, organizational, planning, problem solving and project/decision facilitation skills required.

Ability to travel may be required.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS43825-California

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