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Anthem, Inc. Regional Vice President II Sr Clinical Officer (MO,KY,WI) in Hanover, Maryland

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 care companies and a Fortune Top 50 Company.

Anthem is conducting a national search for Regional Vice President II, Sr. Clinical Officer, to build and lead a best-in-class Network and Care Delivery Transformation Organization, providing clinical expertise, leadership, and oversight of care management to drive strategic priorities at the State Health Plan level. The role will be accountable for partnering with other health plan leaders to determine and improve factors contributing to variations in health care cost and quality. Leadership experience is essential to manage a team of 6-8 Medical Directors while collaborating with Plan Presidents, vendors, and leaders across the organization including sales executives.

Some of the key priorities for the RVP II, Sr. Clinical Officer will include excelling at running operations for the Network and Care Delivery Organization in their current state and reimagining the future state to enable industry-leading capabilities. The role will drive the creation of a more efficient organization aligned with the business and to provide clinical leadership and oversight of care management to drive strategic priorities at the State Health Plan level.

Qualifications

  • Sets and executes priorities to improve health care cost and quality

  • Directs staff to improve health care costs and quality for members

  • Interprets existing policies and develops or adopts 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

  • Directs and manages the medical management staff to ensure 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 as needed

  • May chair or serve on company committees and represent Anthem to external entities and/or serves on external

  • committees and provides guidance for clinical operational aspects of the program

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports and directly supervises the management of any assigned staff

  • 10+ years of clinical experience within a managed care organization

  • 10+ years of progressive leadership responsibilities in a highly matrixed organization

  • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills and a dynamic speaker, and analytical skills

  • 5+ years’ experience managing a utilization management team

  • Unrestricted M.D. or D.O. licensure

  • Board certification approved by the American Board of Medical Specialties

  • Must possess an active unrestricted medical license to practice medicine

  • Ability to work in an Anthem office, MO, WI, or KY preferred

  • 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.

Preferred:

  • Commercial line of business experience

REQNUMBER: PS42330-US

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