Medical Director - West Region (Commercial) - 39939SY - (US-CO-Denver - 80299)

Minimum Education: Tech School
Job Type: Full Time
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As the Medical Director: West Region Commercial Accounts you will be responsible for the West Region (California, Colorado and Nevada Commercial Accounts)
participating in a physician team focused primarily on the identification and management of Anthem members who can benefit from improved health care coordination and clinical support. Work with Anthem medical directors who focus on improving Anthem members' health care through improved health care coordination and clinical support. Collaborate with the physician and nursing and non-clinical staff to implement tools, processes, and related skills that will improve member health reduce readmissions and help Anthem members improve their health, supporting Anthem member's medical needs at the most appropriate setting and using the appropriate resources. Additional responsibilities include the administration of medical services for company health plans to ensure clinical integrity of broad and significant clinical programs, including the overall medical process of the business unit. Be a member of the medical management team to improve the efficiency and effectiveness of Anthem's medical management process. Duties may include, but are not limited to: Interprets existing policies and develops 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. 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 WellPoint to external entities and/or serve on external committees.


Skills:
Requires MD and three or more years of experience in managed care. Position will be based in Southern California or Coloradoand report to the Managing Medical Director for Care Coordination and Case/Care Management.

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