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Anthem, Inc. RVP Medical Director - Medicare (Group Retiree Services) in Jefferson City, Missouri


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 position will have responsibility for the Medicare, Group Retiree Services Programs. In this role, the incumbent will be responsible for the administration of company health plan medical services to ensure the appropriate and cost-effective medical care is provided. Oversees medical performance for assigned health services area and clinical decision-making aspects of programs. May also have Healthcare management responsibilities for a state.

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

  • 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

  • Serves on company committees

  • Represents company to external entities and/or serves on external committees

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports


  • Experience working with C-suite externally recommending new programs utilizing clinical expertise and leadership

  • Must be able to travel as COVID restrictions lift nationally to attend and present at client meetings

  • Healthplan or Managed Care experience focused on Medicare and specifically Group Retiree Business preferred

  • Medical Management experience with accountability for managing a team of physicians responsible for UM Review

  • Experience managing a remote team nationwide

  • MD; board certification approved by the American Board of Medical Specialties where applicable to duties being performed; 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background

  • For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills

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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.

REQNUMBER: PS50815-Missouri