Anthem, Inc. Chicago , IL 60602
This position will be located at AIM's corporate office located in Chicago IL, near O'Hare Airport.
Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies, 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.
The Radiology Associate Medical Director supports the clinical integrityof the AIM RBM solution, making sure the programimproves the appropriateness of care, improves patient outcomes and reducescost. The Associate Medical Director supportsthe clinical development of the solution, including the overall strategicapproach, program design, and clinical underpinnings (clinical evidenced basedguidelines that are the foundation for the interventions which will be made byAIM on behalf of its clients.) The AssociateMedical Director contributes to program innovation and evolution over time toincrease efficiency and impact.
The Associate Medical Director participates in salesmeetings with prospective clients (including preparation, value estimateassessment and, input on the characteristics of the local medical market) asone of the program/solutions clinical experts. This will also include meetings with prospects' clinical leadership toensure they understand the clinical basis for the solution. The Associate Medical Director supports thecompletion of RFIs and RFPs and other sales activities as needed to support thegrowth in (membership and revenue) of the solution.
The Associate Medical Director supports clientimplementations and is a key member of the team supporting the client and inparticular the client's clinical leadership after implementation. This includes developing provider acceptanceand support, answering clinical questions regarding the program, participatingin conversations with the client's key provider partners, as well as statespecialty societies and other medical organizations and institutions.
The Associate Medical Director acts as one of the key clinicalleaders supporting the call center clinical teams with respect to his or hersolution. He or she is also involved inevaluating the solutions performance regarding impact and helping to analyzeexpected versus actual and the causes for any discrepancies. This includes synthesizing feedback fromproviders received directly, through the call center and through our clients toidentify opportunities for improvement from an ease of use perspective and fromand impact perspective.
Primary duties may include but are not limited to:
Provide the clinical expertise necessary to assistin the creation and support of a clinical, evidenced based program to improveappropriateness of care and reduce cost in a specified clinical domain
Work collaboratively alongside the MedicalDirector with the Clinical Content and Authoring Team, the Solutions Team and
Operations, to bring the conceptual "program" to reality
Support sales team and client executives withsales and client management activities as needed and be a clinical resource forthem as well as our clients
Participate as a member of the Clinical SolutionStrategy, Development and Support (CSSDS) team supporting the other members intheir efforts and activities as possible
Monitor competitors' products, emergingcompanies and technologies as sources of ideas for innovation and improvement.
Collaborate with others to continually driveinnovation and improvement that support greater value and ease ofimplementation and use.
Stay abreast of clinical developments andadvances in the specific domain and ensure that as appropriate they areincorporated into AIM's solution.
Ability to represent the public face of thesolution by interacting with professional societies, patient advocacy groups,government agencies, and the press and lay public as needed in collaborationwith AIM marketing and communications.
About AIM Specialty Health:
AIM Specialty health (AIM) is a leading specialty benefitmanagement company that promotes appropriate, safe and affordable healthcareservices. We are a member of the Anthemfamily of companies, which is recognized as one of the nation's leading healthbenefits companies.
AIM provides innovative clinical solutions that focus ontoday's most complex and costly tests and treatments in radiology, cardiology,medical and radiation oncology, specialty drugs, sleep medicine,musculoskeletal and pain management, genetic testing, palliative care, andother emerging clinical areas.
With evidence-based medicine, technology, people, andprocesses, we support clinical appropriateness review, provider collaboration,and member engagement on behalf of more than 50 health plans, 40% of the
Fortune 50 Employers, and 50 million members.
Today our team includes more than 1,100 associates andfeatures more than 600 licensed and board-certified physicians, nurses andother healthcare professionals who engage with more than 330,000 health careproviders across the country. Thesehealthcare providers access our solutions and specialized clinical expertisethrough our online Provider Portal and experienced contact center-based teamsthat are enabled by our business platform.
Our pioneering spirit and dedication to improvehealth care continue to produce significant industry-first advancements,quality recognition achievements, and high user satisfaction rates. AIM is certified by the National Committeefor Quality Assurance (NCQA) and has received full accreditation for HealthUtilization Management from the Utilization Review Accreditation Commission(URAC.)
Medical Doctor currently licensed and boardcertified in Radiology
5 years of clinical experience or any combination of education and experience, which would provide an equivalent background.
Utilization management, casemanagement, utilization review, or health care management experience helpfulbut not required
Experience in clinical coding (ICD-10, CPT,etc.), experience in medical informatics, and EMR experience all helpful butnot required.
Demonstrated ability to work collaborativelywith other clinicians and non-clinicians
Demonstrated experience and effectiveness inmotivating and mentoring others who are in a direct reporting relationship
Ability to communicate effectively in writing,orally and with others to assimilate, understand and convey information in amanner consistent with job functions. Prepare clear and concise reports, correspondence, thought leadershippieces and other written materials.
Demonstrated ability to deliver effectivepresentations to all size groups
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.