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Medical Director - PS37906 Location: New Haven, CT
Job Family: Medical
Req #: PS37906
Date Posted: Aug 19, 2020
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 care companies and a Fortune Top 50 Company.
Medical Director - Remote
This position will be supporting our North East Commercial
Responsible for the administration of medical management
services for company health plans and ensures clinical integrity of
broad and significant clinical programs, including the overall
medical policies of the Commercial business unit. Will be reporting
to the Director of Medical Operations.
Primary duties may include, but are not limited to:
Evaluates requests for service coverage for medical
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
Supports the Medical Management staff ensuring timely and
consistent responses to members and providers.
Identifies and develops opportunities for innovation to increase
effectiveness and quality.
Serves as a resource and consultant to other areas of the
May chair or serve on company committees.
May be required to represent Anthem to external entities
and/or serve on external committees.
M.D. or D.O. – an active state license required
ABMS Board certification required.
Internal or Family Medicine Board Certification preferred.
Other specialties will be considered.
5 years clinical experience or any or any combination of
education and experience, which would provide an equivalent
Previous UM/appeals experience preferred.
Managed care background preferred.
Strong oral and written communication skills 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.
Anthem, Inc. is ranked as one of America’s Most Admired
Companies among health insurers by Fortune magazine and is a 2019
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 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.
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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.