Description
SHIFT: Day Job
SCHEDULE: Full-time
Be part of an extraordinary team. We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
CareMore is a proud member of the Anthem family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.
Title: CareMore Regional Chief Medical Officer - East
Location: Remote or within commutable distance to one of our Pulse offices
The incumbent will be responsible for partnering with business, operations, and growth leaders to support business growth in the defined markets. Maintains a high level of touch with prospects and members to ensure that aggressive growth targets are achieved. In addition to having direct oversite for clinical operations and medical staff within the East region.
Primary duties may include, but are not limited to:
Leads clinical performance and strategy for multiple markets and is accountable for population clinical outcomes and quality, clinical staffing and training, care coordination and alignment with network providers, and overall clinical and financial performance
Oversees each market including hospitals; care centers; home visits; and network provider offices to optimize clinical and financial performance
Provides strategic and operational direction for the delivery of performance-based medical management
Responsible for clinical outcomes across acute and post-acute care, ambulatory care and chronic disease management, and specialty care for all patients and markets under purview
Monitors data to ensure that network providers are providing high-quality service to members at a reasonable cost; are effectively working to improve clinical performance, coding, and HEDIS/Star gap measures; and meets regularly with critical primary care and specialty groups to ensure that there is a deep understanding of both performance expectations and the CareMore model
Manages budget and risk drivers
Analyzes and reports business performance data to customers, senior management, and company leadership
Analyzes local profit and loss performance
Contributes to the internal and external health industry development efforts
Hires, trains, coaches, counsels, and evaluates the performance of direct reports
Qualifications
Requires MD or DO and minimum of 5 years of experience as a hospitalist or internist and minimum of 10 years combined administrative and leadership experience; or any combination of education and experience, which would provide an equivalent background.
Requires current unrestricted medical licensure in applicable state(s).
Board certification from the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) is required.
For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position.
Preferred Skills, Capabilities, and Experiences:
6 years combined leadership & administrative experience from a healthcare organization
Experience in inpatient and outpatient care delivery models servicing Medicare and Medicaid patients
Experience in Medicare Advantage with dual, chronic, and institutionalized special needs plan patients
Experience in Utilization Management and Cost of Care initiatives
Understanding of CMS regulations
Experience in partnering through CMS Audit process
Understanding of Hospital systems coupled with Healthplan knowledge
Internal, and or Family Medicine specialty highly desirable
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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work ForR, 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. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.
REQNUMBER: PS71173
