Anthem, Inc. Mgr II Grievance/Appeals in Midland, Georgia
SHIFT: Day Job
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.
This position will allow remote start due to Covid but will move to office based once Anthem is cleared to return to the office (TBD). Required office options: Denver, CO; Mason, OH; Indianapolis, IN; Richmond, VA; Virginia Beach, VA or Midland, GA
Responsible for management oversight of grievances and appeals departmental units to investigate, resolve, and respond to client/provider grievances/appeals and ensure compliance with regulatory requirements.
Primary duties may include, but are not limited to:
Maintains and coordinates staff activities to achieve departmental and corporate goals to improve service to customers/providers/regulators and assures regulatory compliance for multiple states.
Analyzes and develops strategies by achieving performance thresholds within budgetary guidelines.
Addresses both internal/external customer/provider needs and concerns related to team activities.
Ensures programs support overall QI program and meet regulatory compliance/accreditation and the company standards.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
The work managed by this manager has rigid timeframes and requires interactions with all levels of internal management and external government agencies.
Requires 5 + years grievance & appeals experience and 3-5 years of management experience in the healthcare industry; or any combination of education and experience, which would provide an equivalent background.
For URAC accredited areas the following applies: Requires demonstrated strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Applicable to Colorado Applicants Only Annual Salary Range*: $67,954 - $84,945 Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. * The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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.