/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 benefits companies and a Fortune Top 50 Company.
Working in close collaboration with the Director, Oncology Solutions and AIM, the Oncology Medical Director is responsible for providing clinical leadership and industry expertise for the design and delivery of oncology related strategies supporting Anthem’s Commercial and Government business units.
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In partnership with the oncology team, will be responsible for jointly leading the development and implementation of enterprise-wide clinical strategies for oncology (including genetics) and advanced illness to improve quality, safety, patient-centeredness, and affordability.
Accountable for strengthening provider/practice relationships to influence behavior changes in improving key quality and performance measures that will have substantial impact on member health outcomes as well as the value of healthcare.
Serve as the oncology expert to educate/address/resolve clinical inquiries from external providers and internal partners. Establish partnerships across multi-functional departments, such as with Health Care Management, National Provider Solutions, Payment Innovation, Provider Enablement, Public Policy, Research (HealthCore), Community Health, and Communications to achieve common goals and cost of care results.
Primary duties may include, but are not limited to:
* Jointly partnering with Anthem’s oncology provider engagement team to build and strengthen relationships with physician leaders, practices, and facilities to increase participation in Anthem’s programs, improve quality and performance metrics aimed at achieving optimal health outcomes for members.
* Lead Anthem’s efforts to engage with external constituencies, e.g. medical specialty societies, policy organizations, and patient advocacy groups regarding their priorities for improving access to quality and affordable care in the clinical domain.
* Ensures alignment of oncology/advanced illness clinical strategies with the goals of Anthem’s Commercial and Government Business, Health Care Management and Corporate Strategy, as well as the efforts of the Blue Cross and Blue Shield Association to promote value and quality of care.
* Contribute and support Corporate Strategy initiatives by providing insights and sharing clinical science innovations impacting health care delivery and payment models that may require new capabilities or business partnerships.
* Ensure the integrity of the clinical quality programs, including alignment with Anthem Medical Policies and Utilization Management Clinical Guidelines if applicable, observance of corporate governance and polices, and reporting into appropriate committees (e.g. Enterprise Clinical Quality Committee). May also serve on other quality committees, within Anthem, local states, or nationally to advance discussions to transform cancer care, quality measures, and alternative payment systems.
Responsible for serving as a Medical Director of the National Accounts business unit, leading the strategic implementation of improving the health of the people we serve, influencing product strategy and design and medical management approaches that impact health care quality, cost, and outcomes, and improving access to and usefulness of health improvement tools offered to National Account members.
* Monitors competitor products and internal medical management capabilities and responds with recommendations for improvement in company models.
* Contributes to development of Medical Management and Quality Management strategies. Responsible for consistent adoption and implementation of all medical policies.
* Provides clinical leadership for Utilization Management, Case Management, Disease Management, and Quality Management of National Accounts in cooperation with Regional Health Care Management (HCM) team and Chief Medical Officer.
* Provides clinical expertise in sales planning and participates in the acquisition and retention of National Accounts.
* Collaborates with HCM leaders to refine and improve provider and medical management services to meet the needs of National Accounts.
* Assures the clinical relevance of account reporting regarding use of medical services by National Accounts members.
* Communicates medical management trends and recommends company medical management responses to National Accounts.
* Contributes to efforts to establish effective physician and hospital quality and cost profiling and education. Contributes to improved provider relationships and national associations and societies (i.e., AMA, Coalition of Specialty Societies).
* Represents company at nationally recognized speaking engagements to promote health programs.
* Strong business acumen, effective communications, and public speaking skills, with knowledge of health plan operations, provider/practice business operations, and financial management required.
* 10 years of clinical in oncology, quality, and/or research experience or any combination of education and experience, which would provide an equivalent background
* M.D. or D.O.; and12 years of healthcare experience with extensive managed care knowledge; or any combination of education and experience, which would provide an equivalent background.
* Requires current unrestricted medical licensure in US state of residence.
* Current ABMS recognized board certification in Oncology or related specialty required.
* Requires experience with population or segment health management and the education and coaching of members on wellness, prevention, and healthy lifestyles.
* Knowledge of leading competitive product offerings in the healthcare industry and marketplace standards and knowledge of National Accounts expectations required.
* MBA or related degree preferred.
*/Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2015 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran./*
**Job** *Medical*
**Title:** *Medical Director National - Oncology - 123953*
**Location:** *IL-Chicago*
**Requisition ID:** *123953*