Anthem, Inc. RVP - Sr. Clinical Officer - NY in Springfield, Missouri
SHIFT: Day Job
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.
The incumbent for this role will be responsible for providing strategic leadership for an assigned state(s) NY, ME, NH, & CT with revenue between 1.9 billion and 5 billion. Responsible for providing clinical expertise leadership and oversight of care management to drive strategic priorities at the State Health Plan level. Is accountable for partnering with other health plan leaders to determine and improve factors contributing to variations in health care cost and quality.
Primary duties may include, but are not limited to:
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 serve on external committees and provide guidance for the program's clinical operational aspects.
Hires, trains, coaches, counsels, and evaluates the performance of direct reports and directly supervises the management of any assigned staff.
Requires M.D. or D.O.; Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA); must possess an active unrestricted medical license to practice medicine or a health profession in a state or territory of the United States.
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.
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.