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Description SHIFT: Day JobSCHEDULE: Full-timeYour 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. U tilization Management Representative II – Crisis Line Team As a Utilization Management Representative II on the Crisis Line team, you will be taking calls from our members in their time of greatest need. You will be responsible for managing incoming calls, including triage, opening of cases and authorizing sessions. Handling Crisis Line calls will require de-escalation and providing resources. A background working with mental health or behavioral health populations is strongly preferred. This position is fully remote, requiring a dedicated office space where confidentiality can be maintained without distractions. The nature of a Crisis Line is that it is available in times of need, which are often outside of core business hours. Some associates will be assigned to work evenings, overnight and weekends. Holiday coverage will be required. This team will be assembled for a December 6, 2021 start date with 4 weeks of training required. Primary duties may include, but are not limited to: Managing incoming calls or incoming post services claims work. Determining contract and benefit eligibility Obtains intake (demographic) information from caller. Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given. Verifies benefits and/or eligibility information. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Here’s what Anthem offers: A career path with opportunity for growth Ability to obtain your Associate’s or Bachelor’s degree or further your education with tuition reimbursement. Affordable Health Insurance, Dental, Vision and Basic Life 401K match, Paid Time Off, Holiday Pay Quarterly incentive bonus and annual increases plan based on performance. At Anthem, the team is comprised of the best and the brightest from diverse experiences, cultures, and backgrounds. The differences we each bring to the table are a part of what makes our company so successful. Qualifications Required: Bachelor’s degree or equivalent and a minimum of 2 years customer service in healthcare related setting and medical terminology training; Or any combination of education and experience, which would provide an equivalent background. Ability to work from home with internet access and a quiet and private work space Preferred: Crisis line or mental healthcare experience Master’s Degree Soft Skills: De-escalation skills Motivational interviewing or similar skills Strong oral, written and interpersonal communication skills Problem-solving skills Facilitation skills Analytical skills 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. has been named as a Fortune 100 Best Companies to Work For® , is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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: PS60601
Vacancy expired!