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LTSS Service Coordinator-Auditor

Company: Anthem, Inc.
Location: Miami
Posted on: February 25, 2021

Job Description:

Welcome to the Anthem Careers site! We have been hard at work to improve our job search and application systems to better serve you. It is now easier to find and apply for relevant jobs as well as stay connected with Anthem. Here are a few of the updates you may notice:

  • No more profiles! We no longer require you to create a log in and password to apply for a job and you won't be able to access previously created profiles, but don't worry - we still have your previous application(s) on file and you can still track your status by clicking on the "Track Your Job Application Status" button.
  • Job Alerts - If you had previously registered to receive job alerts and wish to continue to receive these notifications, please re-register by clicking the "job alert" button.
  • NEW! Didn't find a job that is right for you? Join a Talent Network to stay informed on news and job opportunities with the Anthem Team! It is important that you apply using an email address which is unique to you and not shared with a friend, relative, spouse, or significant other. Our recruiting system uses your email address as your unique identifier. If you apply with a shared email address, your application will overwrite any previous applicant record with the same email address. Additionally, please ensure that you use a valid email address, free from typos, as there are a variety of communications which may be sent to the email address with which you apply 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. The--LTSS Svc Coord-Auditor--is responsible for auditing member individual service plans within the scope of position, as required by applicable state law and contract.--The audit process does not involve clinical judgment.-- Primary duties may include, but are not limited to:--
    • Audits program needs assessments and member's long term service and support needs to ensure that established service plans are appropriate.
    • --Audits to determine whether members with potential clinical health care needs (including, but not limited to, potential for high risk complications) are coordinated with the clinical healthcare management and interdisciplinary team.
    • Audits to determine whether the non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, are being met to insure cost effective and efficient utilization of long term services and supports.--
    • Audits the short and long term service and support goals that were established for the member and ensures the level of service and/or waiver programs are appropriate.--
    • Documents audit findings, identifies issues and informs management. Assesses and identifies training opportunities for the staff. Qualifications Auditors shall meet one of the following qualifications:
      • Auditors with the following qualifications shall also have a minimum of two-- --years of relevant experience:

        (a)Bachelor's degree in social work, sociology, psychology, gerontology, or a related social services field;

        (b)Registered nurse, licensed to practice in the State;

        (c)Bachelor's degree in a field other than social science; or
        --
        • Auditors with a master's degree in social work, sociology, psychology, gerontology, or a related social services field may substitute experience obtained through a practicum, internship, or clinical rotation on an equivalent basis for up to one (1) year of the experience requirements.(a)Auditors with the following qualifications shall also have a minimum of four (4) years of relevant experience: Licensed Practical Nurse, licensed to practice in the State.

          Auditors without the aforementioned qualifications may substitute professional human service experience on a year-for-year basis for the educational requirement. Case Managers without a bachelor's degree shall have a minimum of six (6) years of relevant experience.
          ---
          All Auditors are required to obtain a successful Level II criminal history screening and/or background investigation. 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. Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem. EEO is the Law Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees. Anthem, Inc. is committed to helping individuals with disabilities participate in the workforce and ensuring equal opportunity to apply and compete for jobs. If you are an individual with a disability and require a reasonable accommodation to complete the application process, please email Human Resources at ability@icareerhelp.com for further assistance. *WARNING : Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Please be advised that Anthem will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission here by selecting the 'Rip-offs and Imposter Scams' option. Anthem requires a completed online application for consideration of employment for any position.

Keywords: Anthem, Inc., Miami , LTSS Service Coordinator-Auditor, Accounting, Auditing , Miami, Florida

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