Medical Director Associate

<em><span style="font-family: arial, sans-serif;">Your Talent. Our Vision.</span></em><strong><span style="font-family: arial, sans-serif;">&nbsp;At Anthem, Inc.,&nbsp;</span></strong><span style="font-family: arial, sans-serif;">it&rsquo;s a powerful combination, and the foundation upon which we&rsquo;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&nbsp;<strong>drive the future of health care</strong>.</span>

Iselin NJ

Anthem, Inc.

<div id="wrapper"> <div id="contentArea"> <div class="mainContent_leftrightCol"> <div class="content_Main"> <p class="Default" style="margin: 0px 0in; padding-top: 0px; padding-bottom: 0px;">Anthem is working to transform health care with trusted and caring solutions. Our health plan companies deliver quality products and services that give their members access to the care they need. With over 74 million people served by its affiliated companies, including approximately 40 million within its family of health plans, Anthem is one of the nation's leading health benefits companies.</p> </div> </div> </div> </div>

keywords: innovation,support,teamwork,consulting,support,experience,medical,certification


Overview: <p style="font-weight: 400;">This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.<br /><br />Responsible for providing day to day guidance, support, and leadership for the clinical and quality activities and supporting the Medical Director in ensuring the clinical integrity of broad and significant clinical programs and identifies and develops opportunities for innovation to increase effectiveness and quality of care management processes and activities.&nbsp;</p>
Responsibilities: <p style="font-weight: 400;">Primary duties may include, but are not limited to:</p> <ul style="font-weight: 400;"> <li style="font-weight: 400;">Provides support to clinicians in daily tasks and ensuring timely and consistent responses to members and providers, conducts peer to peer clinical reviews with attending physicians or other ordering providers to discuss review determinations, office visits with providers and external physicians as necessary.</li> <li style="font-weight: 400;">May participate in a physician on-call rotation for a 24x7 pre-certification unit, assists in the practitioner appeal reviews, appropriateness criteria reviews, medical policy and technology assessments, setting and implementing QI initiatives, and practitioner/provider credentialing.</li> <li><span style="font-weight: 400;">Serves as a resource and consultant to other areas of the company and may be required to represent the company to external entities and/or serve on external committees, and 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.</span></li> </ul>
Requirements: <ul style="font-weight: 400;"> <li style="font-weight: 400;">Requires M.D. or D.O.</li> <li style="font-weight: 400;">Requires current ABMS board certification.</li> <li style="font-weight: 400;">Requires current, unrestricted medical license issued by the State of NJ.</li> <li style="font-weight: 400;">Requires 5 years of clinical experience&nbsp;</li> <li style="font-weight: 400;">Managed care experience preferred.</li> <li style="font-weight: 400;">Ability to work in Anthem Iselin, NJ office.</li> </ul>