Company: Anthem, Inc.
Posted on: January 9, 2022
UPDATED 12/9/21: The health of our associates and communities is
a top priority for Anthem. We require all new candidates to become
vaccinated against COVID-19. If you are not vaccinated, your offer
will be rescinded unless you provide - and Anthem approves - a
valid religious or medical explanation as to why you are not able
to get vaccinated that Anthem is able to reasonably accommodate.
Anthem will also follow all relevant federal, state and local laws.
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. Responsible for the administration of
physical and/or behavioral health medical services, to ensure the
appropriate and most cost effective medical care is received. May
be responsible for developing and implementing programs to improve
quality, cost, and outcomes. May provide clinical consultation and
serve as clinical/strategic advisor to enhance clinical operations.
May identify cost of care opportunities. May serve as a resource to
staff including Medical Director Associates.
- May be responsible for an entire clinical program. Primary duties
may include, but are not limited to:
- Supports clinicians to ensure timely and consistent responses
to members and providers.
- Provides guidance for clinical operational aspects of a
- Conducts peer-to-peer clinical reviews with attending
physicians or other providers to discuss review determinations, and
patients' office visits with providers and external
- May conduct peer-to-peer clinical appeal case reviews with
attending physicians or other ordering providers to discuss review
- Serves as a resource and consultant to other areas of the
- May be required to represent the company to external entities
and/or serve on internal and/or external committees.
- May chair company committees. Interprets medical policies and
- May develop and propose new medical policies based on changes
- Leads, develops, directs and implements clinical and
non-clinical activities that impact health care quality cost and
- Identifies and develops opportunities for innovation to
increase effectiveness and quality.
- This level may provide oversight, direction and guidance to
Medical Director Associates.
- Works independently with oversight from immediate manager.
- May be responsible for an entire clinical program and/or
independently performs clinical reviews.
- The Medical Director typically has program management
responsibilities including clinical policy development, program
development/implementation, and overseeing clinical/non-clinical
- Requires MD or DO and 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).All specialties
considered except Behavioral Health.
- Must possess an active unrestricted medical license to practice
medicine or a health profession in any state. 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.
- Minimum of 10 years of clinical experience; or any combination
of education and experience, which would provide an equivalent
Preferred Qualifications: -
- Preferred Georgia Residency but not a requirement.
- Team player, collaborative, and capable of independent work.
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. Please be advised that Anthem only accepts resumes from
agencies that have a signed agreement with Anthem. Accordingly,
Anthem is not obligated to pay referral fees to any agency that is
not a party to an agreement with Anthem. Thus, any unsolicited
resumes, including those submitted to hiring managers, are deemed
to be the property of Anthem. EEO is the Law
EqualOpportunityEmployer/Disability/Veteran Please use the links
below to review statements of protection from discrimination under
Federal law for job applicants and employees. This may be subject
to modification depending on the state in which the applicant
resides. Fully vaccinated means it has been at least two weeks
since you have received the second dose of a two-dose vaccine or
the single dose of a single dose vaccine-the Johnson & Johnson
vaccine. Anthem, Inc. is committed to helping individuals with
disabilities participate in the workforce and ensuring equal
opportunity to apply and compete for jobs. If you are an individual
with a disability and require a reasonable accommodation to
complete the application process, please email Human Resources at
email@example.com for further assistance. *WARNING: Please
beware of phishing scams that solicit interviews or promote
work-at-home opportunities, some of which may pose as legitimate
companies. Please be advised that Anthem will never ask you for a
credit card, send you a check, or ask you for any type of payment
as part of consideration for employment with our company. If you
feel that you have been the victim of a scam such as this, please
report the incident to the Federal Trade Commission here by
selecting the 'Rip-offs and Imposter Scams' option. Anthem requires
a completed online application for consideration of employment for
Keywords: Anthem, Inc., Gilbert , Medical Director, Healthcare , Gilbert, Arizona
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