Responsible for the administration of medical management services for company health plans and ensures clinical integrity of broad and significant clinical programs, including the overall medical policies of the Commercial business unit. Will be reporting to the Director of Medical Operations.

Primary duties may include, but are not limited to:

• Evaluates requests for service coverage for medical necessity.
• Interprets existing policies and develops new policies based on changes in the healthcare or medical arena.
• Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes.

Qualifications:

• M.D. or D.O. required,
• An active unrestricted ME state license required.
• ABMS Board certification required.
• 5 years clinical experience or any combination of education and experience, which would provide an equivalent background.
  

For more information and to apply visit:  https://anthemcareers.ttcportals.com/jobs/6345868-medical-director-me-license-required

4/22/21