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.
Responsible for leading the development, implementation and evaluation of clinical interventions and cost of care management strategies for all customer business segments. Primary duties may include, but are not limited to:
Establishes and executes clinical intervention programs.
Evaluates and implements clinical quality and cost of care programs.
Manages clinical and economic rule sets used in the pharmacy care note communications. Supports enterprise accreditation process.
Collaborates with the Care Management team to improve medication compliance and reduce hospital re-admissions.
Provides Request for Proposal (RFP) support and assists with business growth and client retention.
Manages budget and increases clinical product revenue.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires a PharmD; 5 years of managed care experience with specific knowledge of OIG, ERISA, HIPAA and regulatory environment, DSM / HEDIS / Quality Improvement / Clinical Interventions program development and oversight; or any combination of education and experience, which would provide an equivalent background.
Current pharmacist license required.
Analytics experience with SAS/SPSS/SQL/Tableau required.
PhD or MPH preferred.
Drug trend report experience highly preferred.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran