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Medical Director - Central Region

Location: , MO
Job Family: Medical
Req #: PS47809-Missouri
Date Posted: May 9, 2021

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

Full-time Medical Director – Central Region. Will be supporting Indiana and Ohio states. May be located in one of the Central States (IN, OH, MO, KY, WI, TN). 

Responsible for the administration of medical services for company health plans including the overall medical policies of the business unit to ensure the appropriate and most cost effective medical care is received and for the day-to-day management of medical management staff.

Primary duties may include, but are not limited to:

  • Interprets existing policies and develops new policies based on changes in the healthcare or medical arena.
  • Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes.
  • Identifies and develops opportunities for innovation to increase effectiveness and quality.
  • Serves as a resource and consultant to other areas of the company, may chair or serve on company committees, may be required to represent the company to external entities and/or serve on external committees, conduct peer clinical and/or appeal case reviews and peer to peer clinical reviews with attending physicians or other ordering providers to discuss review determinations, provides guidance for clinical operational aspects of the program.
  • Supports the medical management staff ensuring timely and consistent responses to members and providers.

Qualifications

  • M.D. or D.O required.
  • Board certification approved by the ABMS or AOA required. Family Medicine, Internal Medicine, OBGYN, or Pediatrics highly preferred. Other specialties may be considered. 
  • MBA or MPH degree a plus. 
  • Must possess an active unrestricted medical license to practice medicine in the states listed in the posting. 
  • 5 years of clinical experience or any combination of education and experience, which would provide an equivalent background required.
  • 1 - 3 years UM, managed care experience preferred.
  • Occasional travel to an Anthem office may be required. 
  • Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. 

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.

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.

 

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