HMC Medical Director National

WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.
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HMC (Health Management Corporation) is a wholly owned subsidiary of WellPoint, Inc. The WellPoint family of companies provides health care benefits to approximately 34 million people and is the largest publicly traded commercial health benefits company in the United States.


 

Job Title: Medical Director

Location: 220 Virginia Ave, Indianapolis, IN

 

 

Serves as Medical Director of National Business Unit. Participates in leading the strategic implementation of improving the health of the people we serve. Influences product strategy and design and medical management approaches that impact health care quality cost and outcomes. Improves access to and usefulness of health improvement tools offered to National Account members. Primary duties may include, but are not limited to: Monitors competitor products and internal medical management capabilities and responds with recommendation for improvement in Anthem models. Contributes to development of Medical Management and Quality Management strategies. Responsible for assurance of consistent adoption and implementation of all medical policy in the National Business Unit, UM and CM policy, benefit policy, reimbursement policy by Regional HCM teams who service National business. Provides clinical leadership for Utilization Management, Case management, Disease Management and Quality Management of National Accounts in cooperation with Regional HCM team and Chief Medical Officer. Provides medical expertise in sales planning and participates in the acquisition and retention of National Accounts. Collaborates with Health Care Management leaders to refine and improve provider and medical management services to meet the needs of National Accounts. Assures the medical relevance of account reporting regarding use of medical services for National business accounts members. Communicates medical management trends and recommends Anthem medical management responses to National Accounts in a concise and confident manner. Contributes to efforts to establish effective physician and hospital quality and cost profiling and education. Contributes to improved provider relationship with critical provider groups and national associations and societies, i.e, AMA, Coalition of Specialty Societies. Represents Anthem at nationally recognized speaking engagements to promote Anthems health programs in support of Chief Medical Officer's office.Requires M.D and 12 to 15 years of healthcare experience with extensive managed care knowledge. This includes in-depth experience with population or segment health management, and the ability to educate and coach members on wellness, prevention, and healthy lifestyles. Experience with large employers and product design to meet the needs of sophisticated employers would be an asset. Knowledge of leading competitive product offerings in the healthcare industry and marketplace standards. Deep knowledge of National Accounts expectations is necessary. Strong understanding of health management with demonstrated ability to influence members� health behaviors.