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 stay
connected with Anthem. Here are a few of the updates you may
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. Due to technical difficulties
currently being resolved, the ‘Track Your Job Application Status’
functionality is not available.
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
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
Director II Medicare Operations (PS36933) Your Talent. OurVision
. At Anthem, Inc., it’s a powerful combination, and the
foundationupon which we’re creating greater access to care for our
members, greater valuefor our customers, and greater health for our
communities. Join us and togetherwe will drive the future of health
This is an exceptional opportunity to do innovative workthat
means more to you and those we serve at one of America's leading
healthbenefits companies and a Fortune Top 50 Company.
Work Location - Office based: Coconut Grove, FL
Responsible fordirecting multiple business function operations
teams with primaryresponsibility for but is not limited to: Claims,
Medical Policy/Review,Grievance & Appeals, Overpayment Recoveries,
and System Configuration. Primaryduties may include, but are not
Responsiblefor Part A/B Claims processing, pre-pay and post-pay
medical review activities,development and reconsideration of
medical review policies for Part A/B; andthe analysis of data to
review the impact of medical policy application as wellascertain
adherence to the policies.
Directs theactivities of all Part A, B, and DME
re-determinations; Administrative LawJudge (ALJ) appeals; clerical
error re-openings; and the investigation andrecoupment of all claim
overpayments and subrogation of those claims whereMedicare should
be the secondary payer.
Responsiblefor data mining & reporting, identifying
opportunities for improvement andconsistency of decisions, and the
CMS quality and timeliness standards.
Responsiblefor System Configuration for both benefit and payment
Drivesinnovation throughout the assigned business function areas
to reduce theoverall costs associated with performing the CMS
Participatesin leadership forums and reports on operational
updates as needed.
Hires, trains,coaches, counsels, and evaluates performance of
Requires a BA/BS in a related field; 10 years of
professional/leadership experience with CMSincluding areas such as
operations, claims, configuration strategic planning,project
management, Medicare or related healthcare insurance or medical
policyfield, 3- 5 years of management experience; or any
combination of education andexperience, which would provide an
equivalent background. Moderate travel isrequired.
Anthem, Inc. is ranked as one of America’sMost Admired Companies
among health insurers by Fortune magazine and is a 2019DiversityInc
magazine Top 50 Company for Diversity. To learn more about
ourcompany and apply, please visit us at careers.antheminc.com. An
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
email@example.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.