Medical Mgmt Specialist II
Job title: Medical Mgmt Specialist II Company: Job description : 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. Responsible for providing non-clinical support to medical management operations, which includes handling more complex file reviews and inquiries from members and providers. Primary duties may include, but are not limited to: Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review). Conducts initial review of files to determine appropriate action requi...