Description
SHIFT: Day Job
SCHEDULE: Full-time
Location: Remote
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?
Build the Possibilities. Make an extraordinary impact.
The Anthem Digital team is focused on developing a novel approach to payment integrity focused on efficient and high-fidelity processes. You will play a critical role in providing clinical support and guidance to the team of data scientists, product managers, and business leaders responsible for the creation of this new product. In this role, you will use your expertise and deep knowledge of the payment integrity process, ensuring accurate and timely management of all stages of claims processing. Your work will involve close partnership with product and data science teams, advising and supporting them to ensure that clinical guidelines, member outcomes, bias, and safety are all considered as the team builds artificial intelligence and machine learning algorithms into their core product. You will also ensure that impacts on provider workflows and relationships are considered in the product. In doing so, you will represent Anthem in partnerships and working groups with practicing clinicians throughout the Anthem ecosystem to ensure that the payment integrity product meets the needs of all relevant stakeholders. In all of your work across both these key responsibilities as well as any other areas you are involved in, you will apply your clinical knowledge and expertise to support a wide variety of initiatives in digital health, always focused on measurably improving health outcomes for Anthem members.
How you will make an impact:
Collaborates with physicians and business leaders across the clinical organization to define the future of clinical strategy and roadmap within the digital organization and Anthem.
Develops strategy and roadmaps regarding our physician facing products and designs solutions for underserved members with specialists such as clinicians, behavioral economists, and technologists.
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. Influences internal and external stakeholders on both the patient and provider-side. Identifies and develops opportunities for innovation to increase effectiveness and quality of clinical programs.
Focus on technology (business side of innovation): Serves on external technology development committees for setting industry standards in clinical practice. Collaborates with others in the development of market viable business models for innovative products.
Writes clinical requirements for innovative products and services to represent both the needs of the patient and the provider.
Works with clinical teams to ensure that near term business needs are being addressed through innovative projects.
Focus on clinical data and informatics (clinical credibility): Drives publication of key results of interventions and studies to prove member, medical and scientific benefit.
Engages with key stakeholders within medical associations to drive conversations around an evolving standard of care.
May be called on to support various Anthem Digital initiatives or products, ensuring the Digital Care Solution team's work is used to drive clinical integrity across all digital health programs, member-facing products and programs, and provider-facing products and programs.
May also participate in activities such as appropriateness criteria reviews; medical technology assessments; implementing remote patient monitoring tools; and creating and executing QI initiatives that support digital health interventions across both member- and provider-facing applications.
Qualifications
Minimum Requirements:
Requires MD or DO
Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
Must possess an active unrestricted medical license to practice medicine or a health profession.
Minimum of 3 years of post-residency experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Strong oral, written and interpersonal communication skills
Expertise and deep knowledge of the payment integrity process
Problem-solving skills
Facilitation skills
Analytical skills
Digital health product or program development knowledge or experience
Understanding of general user experience design
Understanding of general data science principles, including machine learning
Clinical informatics experience
Process improvement experience
Billing and coding experience
Knowledge and experience with quality metrics (e.g. HEDIS)
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 Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. 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 age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.
REQNUMBER: PS71044-US
