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.
Location: This position offers work from home. Candidates must possess an MN license.
This position will be supporting our Medicaid Amerigroup Business in the state of Minnesota. This is an alliance plan with Blue Cross Blue Shield of Minnesota and will require external interfacing with Blue Cross Blue Shield of MN.
The Behavioral Health Medical Director for MN Medicaid is responsible for the administration of medical services for company health plans including the overall medical policies of the business unit to ensure the appropriate and most cost-effective medical care is received and for the day-to-day management of medical management staff.
Primary 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-effectiveness, and outcomes.
- 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 the company to external entities and/or serve on external committees, 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, provides guidance for clinical operational aspects of the program.
- Supports the medical management staff ensuring timely and consistent responses to members and providers.
- M.D. or D.O. required.
- Active unrestricted medical license to practice medicine or a health profession in Minnesota.
- Board Certified by the American Board of Psychiatry and Neurology in Psychiatry.
- At least 5 years of post-residency clinical experience required.
- MN residency is preferred but not required.
- Addiction certification and/or experience preferred.
- Ability to work collaboratively with a multi-disciplinary team required.
- Knowledge of Medicaid preferred.
- Utilization Management and managed care experience highly preferred.
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.