This clinical leadership position is part of the Anthem Southeast's Regional Medical Affairs team. The individual is responsible for the administration of medical services for the health plan in the local applicable market as well as at the regional level. This includes developing, implementing and overseeing with others overall medical policies in the areas of utilization management (UM), case management (CM) and population health (PH) to ensure the appropriate and most effective medical care is received by members. This individual will work with key others within the health plan to support the day-to-day management of clinical functions by establishing sound methodologies to accomplish objectives and to assure that the organization continues to refine daily management of clinical functions in these areas based on evolving best practices. This individual will play a key role in developing and maintaining business and clinical relationships with strategic provider groups, hospitals and professional societies and select employer groups with primarily a local focus, but with potential for regional relationships as well. He/she will one of the several highly visible "Faces of Quality", helping to define and articulate the clinical leadership and innovative strategies of the newly formed Wellpoint organization.
Support local and regional Utilization Management and Case Management activities
Provide clinical leadership for regional Population Health programs and initiatives
Develop and maintain effective provider relationships
Provide visible medical leadership for Customer Business Units and external entities (legislators, regulators, health coalition as needed)
Provide clinical leadership and general support to the local, regional and enterprise organization
MD required, as well as a current, unrestricted license to practice. 10 years of experience with extensive managed care or Medicare knowledge required. Chosen specialty experience as an OB/GYN, intensivist/cardiologist, or Orthopedics/Rehabilitation preferred. Advanced written, oral and interpersonal communication skills required. Advanced analytical and problem-solving skills required. Excellent computer skills required. Excellent tactical planning and organizational skills required. Proven leadership and project management skills required.
Please apply to job number 10062 by visiting http://careers.anthem.com or send your CV to Kelly.Suter@Anthem.com