Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Performance Quality Auditor I-Ii - Denver CO - Ps11304

Expired Job

Anthem, Inc. Denver , CO 80208

Posted 4 months ago

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 benefits companies and a Fortune Top 50 Company.

Performance Quality Auditor I

Please Note: Manager will determine level based upon the selected applicant's skill-set relative to the qualifications listed for this position.

Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are customer service written and verbal inquiries.

Primary duties may include, but are not limited to:

  • Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.

  • Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.

  • Tracks and trends audit results, providing feedback to management. Identifies and reports on systemic issues which create ongoing quality concerns.

  • Generates monthly reports of audit findings and supports clients with issues identified.

  • Provides coaching and feedback to frontline associates on audit findings.

  • Participates in internal and external calibration sessions.

Performance Quality Auditor II

Please Note: Manager will determine level based upon the selected applicant's skill-set relative to the qualifications listed for this position.

Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are customer service written and verbal inquiries.

Primary duties may include, but are not limited to:

  • Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.

  • Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.

  • Tracks and trends audit results, providing feedback to management.

  • Identifies and reports on systemic issues which create ongoing quality concerns.

  • Generates monthly reports of audit findings and supports clients with issues identified.

  • Provides coaching and feedback to frontline associates on audit findings.

  • Participates in internal and external calibration sessions.

  • Requires High School diploma or GED.

  • 2 years experience including related experience in a quality audit and/or contact center capacity (preferably in healthcare or insurance sector) with consistent above target performance.

  • Ability to acquire and perform progressively more complex skills and tasks in a production environment.

  • Or any combination of education and experience which would provide an equivalent background.

  • Working knowledge of the insurance industry preferred.

  • Understanding of different audit methodologies preferred.

  • Strong verbal and written communication skills required.

  • Excellent interpersonal skills required.

  • Must have high level of initiative and exceptional time management skills.

  • Microsoft Word, Excel and Outlook experience required.

  • Solution Central and Verint experience a plus.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com An Equal Opportunity Employer/Disability/Veteran.


See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Behavioral Health Case Manager L Or II Denver Area 70 Field Work (Ps13677

Anthem, Inc.

Posted 2 weeks ago

VIEW JOBS 11/30/2018 12:00:00 AM 2019-02-28T00:00 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 benefits companies and a Fortune Top 50 Company. Location: You must reside in the Denver area. This position requires field work approximately 70% of the time. When not in the field, you will work from your home office. Please Note: This position may be filled as a Behavioral Health Case Manager I or Behavioral Health Case Manager II. We will determine the level based upon the selected applicant's skill set relative to the qualifications for this position. The BH Case Manager I and ll roles are responsible for performing case management primarily in the field (visiting facilities, provider offices and member homes in the Denver area) and telephonically within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs. Primary duties may include but are not limited to: * Uses appropriate screening criteria knowledge and clinical judgment to assess member needs. * Conducts assessments to identify individual needs and develops care plan to address objectives and goals as identified during assessment. Monitors and evaluates effectiveness of care plan and modifies plan as needed. * Supports member access to appropriate quality and cost effective care. * Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers. The BH Case Manager ll additional responsibilities * May also be a Subject Matter Expert in targeted clinical areas of expertise such as Eating Disorders (ED) Maternity Alcohol / Drug Autism Spectrum Disorders (ASD) etc. * Responds to more complex cases and account specific requests. Uses appropriate screening criteria knowledge and clinical judgment to assess member needs. * Serves as a resource to other BH Case Mgrs. Requirements for BH Case Manager I and ll: * MS or MA in social work, counseling, or a related behavioral health field or a Master's degree in nursing; 3-5 years for Level l (5 – 7 years for Level ll) clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background. * Current active, unrestricted license as an RN, LCSW, LPC, LAC, or LMFT practice as a health professional within the scope of licensure in the state of Colorado required. * Experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred. Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran. Anthem, Inc. Denver CO

Performance Quality Auditor I-Ii - Denver CO - Ps11304

Expired Job

Anthem, Inc.