Anthem Clinical Program Director - Nationwide (128586 KT) in Atlanta, Georgia

Anthem, Inc.is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.

Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.


Clinical Program Director- Nationwide

Responsible for designing, implementing, directing and evaluating strategic programs as well as developing, supporting and maintaining external strategic relationships to support clinical, quality-related or business goals for the company and business unit.

Primary duties may include, but are not limited to:

  • Directs forecasting activities of the business unit focused on setting and achieving short and long-term strategic goals.

  • Ensures accuracy and timeliness of output and deliverables for assigned functional areas.

  • Implements and ensures compliance with corporate management policies, practices, procedures and accreditation requirements.

  • Aligns care management programs to support the specified fiscal responsibility outlined within the departmental budgets.

  • Establishes relationships with cross-functional leadership and business owners.

  • Participates with other senior management to establish strategic plans and objectives and provides supporting presentations demonstrating the necessary elements. (i.e. service level targets, financial targets, development and implementation of new programs).

  • Monitors program outcome metrics and reviews specific program data analyses to assist with the identification, coordination, and drive to operational efficiencies, effectiveness for program improvements and care management decision-making

  • Provides guidance to the state health plans in evaluation of care program data, identification of areas for process improvement, and the identification of potential risk and barriers

  • Leads or participates in project teams and delivers project updates to all areas requiring information for management reporting, analysis and executive decision making.

  • Coordinates and collaborates with training, accreditation, reporting (internal and client) quality as well as all lines of business to remain aligned with program strategy and the delivery of consistent programs and their management.

    Anthem is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at www.wellpoint.com/careers . EOE. M/F/D/V.

    Requirements:

  • BS in nursing or other related clinical area;

  • 7-10 years leadership experience in medical management, case management, or disease management experience or any combination of education and experience, which would provide an equivalent background.

  • Working knowledge of QA/QI concepts

  • Knowledge of accreditation process and requirements for Disease Management/Case Management programs.

  • Working knowledge of Healthy Returns System

  • Proficient in Microsoft Office (Word, Power Point, Excel, Outlook) and SharePoint.

  • Expert oral and written communication skills; highly skilled in developing Power Point presentations and presenting to Sr. Leadership level

    Preferred

  • Current unrestricted RN License

  • Masters’ degree preferred.

  • Certified Case Manager (CCM) preferred.

  • Experience in Case Management/Disease Management Operations delivery preferred.

  • Quality Assurance/Quality Improvement experience desired.

  • Project Management or Business Change Director experience a plus, as well as experience working with Sales/Account Management. * *

/ Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at // antheminc.com/careers // . EOE. M/F/Disability/Veteran. /

Job Medical

Title: Clinical Program Director - Nationwide (128586 KT)

Location: GA-Atlanta

Requisition ID: 128586