Anthem, Inc. RVP II Sr Clinical Officer (Commercial) in Westchester, Illinois
SHIFT: Day Job
Commercial Business Division (CSBD)
Title: RVP II Sr. Clinical Officer
Location: Commutable distance to any Anthem office
Commercial Business Division business unit for the following states: CA, CO, NV, WI, MO, KY, GA, IN, NY, OH, NH, ME, CT and VA.
In this role the incumbent will be responsible for providing strategic leadership for the Commercial Individual business segment. In this role your focus will be clinical expertise, leadership, and oversight of care management to drive strategic priorities at the business segment level. Accountability for partnering with other health plan leaders to determine and improve factors contributing to variations in health care cost and quality while strategically improving out of network usage while managing a team of direct and indirect reports in a highly matrixed organization.
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 serves on external committees and provides guidance for clinical operational aspects of the program
Hires, trains, coaches, counsels, and evaluates performance of direct reports and directly supervises the management of any assigned staff
Requires M.D. or D.O.; board certification approved by the American Board of Medical Specialties where applicable to duties being performed; must possess an active unrestricted medical license to practice medicine or a health profession in a state or territory of the United States
8 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
Healthplan insurance managing clinical cost, affordability, and quality
7+ Healthcare Cost of Care and Quality
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
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
Commercial Business experience
Experience with Change Management, Building teams, steward of culture and vision
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. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.