Anthem Inc. Medical Jobs

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Anthem, Inc. CareMore Regional Chief Medical Officer (East) in Andover, Massachusetts

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At CareMore, a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, it’s a powerful combination. It’s 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.

Title: CareMore Regional Chief Medical Officer

Location: East Region

Responsible for partnering with business, operations and growth leaders to support business growth in the defined markets. Maintains a high level of touch with prospects and members to ensure that aggressive growth targets are achieved.

Responsible for clinical operations and medical staff for the East Region with management responsibility of >250 providers.

  • Leads clinical performance and strategy for multiple markets and is accountable for population clinical outcomes and quality, clinical staffing and training, care coordination and alignment with network providers, and overall clinical and financial performance

  • Oversees each market including hospital; care centers; home visits; and network provider offices to optimize clinical and financial performance

  • Directs regional medical officers

  • Develops tactical plans to meet KPIs

  • Provides strategic and operational direction for the delivery of performance based medical management. Responsible for clinical outcomes across acute and post-acute care, ambulatory care and chronic disease management, and specialty care for all patients and markets under purview

  • Monitors data to ensure that network providers are providing high quality service to members at a reasonable cost; are effectively working to improve clinical performance, coding, and HEDIS/Star gap measures; and meets regularly with critical primary care and specialty groups to ensure that there is a deep understanding of both performance expectations and the CareMore model

  • Manages budget and risk drivers

  • Analyzes and reports business performance data to customers, senior management and company leadership

  • Analyzes local profit and loss performance

  • Contributes to the internal and external health industry development efforts

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

Qualifications

  • Requires an MD/DO; and 7 years of experience as a provider; and 5 years of administrative and leadership experience strongly desired

  • Requires current unrestricted medical licensure in applicable state(s) and board eligibility or board certification

Preferred Qualifications:

  • Experience in inpatient and outpatient care delivery models servicing Medicare and Medicaid patients is highly preferred

  • Experience in Medicare Advantage with dual, chronic and institutionalized special needs plan patients is highly preferred

  • Lean Six Sigma background is a plus

For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers (http://www.wellpoint.com/careers) . AnEqualOpportunityEmployer/Disability/Veteran

REQNUMBER: PS44009-Massachusetts

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