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Medical Director

Company: Anthem, Inc.
Location: Indianapolis
Posted on: March 28, 2020

Job Description:

We're looking for a candidate to fill this position in an exciting company. Interprets existing policies and develops new policies based on changes in the healthcare or medical arena, conduct peer clinical and/or appeal case reviews and peer to peer clinical reviews with attending physicians or other ordering providers to discuss review determinations, provides guidance for clinical operational aspects of the program and leads, develops, directs and implements clinical and non-clinical activities that impact health care quality cost and outcomes.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 the company to external entities and/or serve on external committees.Supports the medical management staff ensuring timely and consistent responses to members and providers.

  • Requires M.D. or D.O.
  • Board certification approved by the American Board of Medical Specialties in Physical and Rehabilitation Medicine required.
  • Must possess an active unrestricted medical license to practice medicine or a health profession.
  • Experience performing DME UM reviews, completing peer to peer reviews, and creating educational protocols--strongly--preferred.
  • Specific knowledge of prosthetics and wheel chairs--strongly preferred.
  • 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.
  • At least 5 --years of clinical experience or any combination of education and experience, which would provide an equivalent background.
  • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Keywords: Anthem, Inc., Indianapolis , Medical Director, Executive , Indianapolis, Indiana

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