Anthem Inc. Medical Jobs

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Anthem, Inc. Medical Director - Neonatology - PS37569 in Palo Alto, California

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.

NICU Medical Director

IN or OH Preferred (Remote)

This position will be supporting our NICU team for the Commercial Business.

This unique position within Anthem will lead the administration of medical management services to newborn members receiving care in Neonatal Intensive Care Units (NICU). Position will be reporting to the Director of Medical Operations.

Primary duties may include, but are not limited to:

  • Evaluates NICU admission and continued stay requests for medical necessity.

  • Leads, develops, directs and implements clinical and non-clinical activities that impact newborn health care quality and outcomes.

  • Interprets existing policies and develops new policies related to acute newborn care.

  • Conducts appeal work and peer to peer conversations.

  • 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.

  • May chair or serve on company committees.

  • May be required to represent Anthem to external entities and/or serve on external committees.

Qualifications

  • M.D. or D.O. – an active state license required.

  • Resident of IN or OH highly preferred but will consider other states.

  • Board Certification in Pediatrics required.

  • Subspecialty in Neonatology required.

  • 5 years clinical experience or any or any combination of education and experience, which would provide an equivalent background.

  • Previous utilization management/managed care experience preferred but not required.

  • Strong track record of leading clinical teams preferred but not required.

  • Strong oral and written communication skills required.

  • 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.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2019 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran REQNUMBER: PS37569-US

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