SHIFT: Day Job
Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s 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.
RVP II Sr Clinical Officer (Medicaid)
Responsible for providing strategic leadership for Medicaid New York, W. New York, New Jersey, Maryland, and Virginia representing 10 billion in annual revenue. Responsible for providing clinical expertise leadership and oversight of care management in order to drive strategic priorities at the State Health Plan level. Is accountable for partnering with other health plan leaders to determine and improve factors contributing to variations in health care cost and quality.
Primary Duties May Include, But Are Not Limited To
- Sets and executes priorities to improve health care cost and quality.
- Directs staff to improve health care costs and quality for members. Interprets existing policies and develops or adopts 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.
- Directs and manages the Medical Management staff to ensure 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 as needed.
- May chair or serve on company committees and represent Anthem to external entities and/or serves on external committees and provides guidance for clinical operational aspects of the program.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports and directly supervises the management of any assigned staff.
Reports To: VP Medicaid Clinical Ops
Staff: 9 direct reports; 12 indirect reports
Relationships: State Plan Presidents
Location: Within commuting distance to an Anthem Medicaid office.
Requires M.D. or D.O.; board certification approved by the American Board of Medical Specialties where applicable to duties being performed; must possess an active unrestricted medical license to practice medicine or a health profession in a state or territory of the United States. 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. 10 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.
- Previous Utilization Review experience.
- Medicaid line of business experience.
- People leadership skills and experience.
- Thought Leader
- Visionary and Strategic Thinker
- Strong Collaborator/Relationship Focused
- Results Oriented
- End to End Influencer
- Inspiring Leader and Developer of Talent
- People leadership experience
Applicable to Colorado Applicants Only
Annual Salary Range*: $286,020 – $357,525
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
- The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.