Anthem Medical Director National - 131013 in Hingham, Massachusetts

/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 willdrive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.

This position will lead and support Anthem's Hospitalization in Home initiative.

Location: Any US location. Work at home may be considered for this role.

Responsible for serving as a Medical Director of the National Accounts business unit, leading the strategic implementation of improving the health of the people we serve, influencing product strategy and design and medical management approaches that impact health care quality, cost, and outcomes, and improving access to and usefulness of health improvement tools offered to National Account members. Primary duties may include, but are not limited to: * Monitors competitor products and internal medical management capabilities and responds with recommendations for improvement in company models. * Contributes to development of Medical Management and Quality Management strategies. * Responsible for consistent adoption and implementation of all medical policies. * Provides clinical leadership for Utilization Management, Case Management, Disease Management, and Quality Management of National Accounts in cooperation with Regional Health Care Management (HCM) team and Chief Medical Officer. * Provides clinical expertise in sales planning and participates in the acquisition and retention of National Accounts. * Collaborates with HCM leaders to refine and improve provider and medical management services to meet the needs of National Accounts. * Assures the clinical relevance of account reporting regarding use of medical services by National Accounts members. * Communicates medical management trends and recommends company medical management responses to National Accounts. * Contributes to efforts to establish effective physician and hospital quality and cost profiling and education. * Contributes to improved provider relationships and national associations and societies (i.e., AMA, Coalition of Specialty Societies). * Represents company at nationally recognized speaking engagements to promote health programs.

  • Requires an MD or DO and 12 years of healthcare experience with extensive managed care knowledge; or any combination of education and experience, which would provide an equivalent background.
  • Requires current unrestricted medical licensure in US state of residence.
  • Current ABMS recognized board certification required
  • Preferred backgrounds include Intensivist, Internist, Hospitalist, or ER
  • Requires experience with population or segment health management and the education and coaching of members on wellness, prevention, and healthy lifestyles.
  • Knowledge of leading competitive product offerings in the healthcare industry and marketplace standards and knowledge of National Accounts expectations required.
  • Ability and desire to travel within the US up to 40% required

/Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran./ _ _

Job Medical

Title: Medical Director National - 131013

Location: massachusetts-Hingham

Requisition ID: 131013