Anthem, Inc. Hiring for Crisis Line Clinical Intake Representative II, III – Job Family at Bradenton, Florida Full Time

Description

SHIFT: Day Job

SCHEDULE: Full-time

Crisis Line Clinical Intake Representative II, III – Job Family

Nationwide – Remote Team; candidates should be within 120 miles of an Anthem location.

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Build the Possibilities. Make an extraordinary impact.

Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Beacon Health Options is a proud member of the Anthem Inc family of companies.

How you will make an impact:

As an Intake Representative 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 and performing clinical intake utilizing specific guidelines and scripts as well as your own skills. You will have direct telephonic contact with members calling in during a crisis, taking those calls off a queue. Handling Crisis Line calls will require de-escalation and providing resources. A background working with mental health or behavioral health populations is strongly preferred. Please note that, internal to the organizaiton, this position title is Utilization Management Representative II or III.

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. At this time, we are seeking candidates who can work 9 AM- 5:30 PM EST Saturday- Wednesday OR 3 PM- 11:30 PM working alternating weekends.

Primary duties may include, but are not limited to:

• Manages incoming calls or incoming post services claims work.

• Obtains intake (demographic) information from caller.

• Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given.

• Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care.

• Verifies benefits and/or eligibility information.

• Conducts clinical screening process.

Level III duties may also include:

• Responsible for providing technical guidance to Reps who handle correspondence and assist callers with issues concerning contract and benefit eligibility for requested continuing pre-certification and prior authorization of inpatient and outpatient services outside of initial authorized set.

• Assisting management by identifying areas of improvement and expressing a willingness to take on new projects as assigned.

• Handling escalated and unresolved calls from less experienced team members.

• Ensuring Reps are directed to the appropriate resources to resolve issues.

• Ability to understand and explain specific workflow, processes, departmental priorities and guidelines.

• May assist in new hire training to act as eventual proxy for Ops Expert.

• Exemplifies behaviors embodied in the 5 Core Values.

Qualifications

This position can be filled at Utilization Management Representative II or Utilization Management Representative III level. The hiring manager will determine the level, based on the candidate’s experience and background.

Minimum Requirements: Level II

Requires HS diploma or equivalent and a minimum of 2 years customer service experience in healthcare related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background.

Level III

Requires a HS diploma or GED and a minimum of 3 years of experience in customer service experience in healthcare related setting; or any combination of education and experience which would provide an equivalent background. Medical terminology training required.

Preferred Skills, Capabilities and Experiences

Applies to both Level II and III

• Crisis line or mental healthcare experience

• Master’s Degree

• De-escalation skills

• Motivational interviewing or similar skills

• Strong oral, written and interpersonal communication skills

• Problem-solving 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.

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. 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. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.

REQNUMBER: PS67684