Anthem, Inc. CareMore Regional Chief Medical Officer (East) in Roanoke, Virginia
SHIFT: Day Job
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
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
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