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Medical Director - PS37906

Company: Anthem, Inc.
Location: New Haven
Posted on: September 12, 2020

Job Description:

Welcome to the Anthem Careers site! We have been hard at work to improve our job search and application systems to better serve you. It is now easier to find and apply for relevant jobs as well stay connected with Anthem. Here are a few of the updates you may notice:

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It is important that you apply using an email address which is unique to you and not shared with a friend, relative, spouse, or significant other. Our recruiting system uses your email address as your unique identifier. If you apply with a shared email address, your application will overwrite any previous applicant record with the same email address. Additionally, please ensure that you use a valid email address, free from typos, as there are a variety of communications which may be sent to the email address with which you apply

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 Business.

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 necessity

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.

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 company.

May chair or serve on company committees.

May be required to represent Anthem to external entities and/or serve on external committees.

Qualifications

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 background.

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 ability@icareerhelp.com for further assistance.

*WARNING : Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Please be advised that Anthem will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam 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.

Keywords: Anthem, Inc., New Haven , Medical Director - PS37906, Other , New Haven, Connecticut

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