23 Sep
Associate Medical Director - AIM Specialty Health
California, Paloalto 00000 Paloalto USA

Vacancy expired!

Description SHIFT: Day JobSCHEDULE: Full-timeAbout AIM Specialty Health:

AIM Specialty health (AIM) is a leading specialty benefit management company that promotes appropriate, safe and affordable healthcare services. We are a member of the Anthem family of companies, which is recognized as one of the nation’s leading health benefits companies.

AIM provides innovative clinical solutions that focus on today’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, and other emerging clinical areas.

With evidence-based medicine, technology, people, and processes, 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 and features more than 600 licensed and board-certified physicians, nurses and other healthcare professionals who engage with more than 330,000 health care providers across the country. These healthcare providers access our solutions and specialized clinical expertise through our online Provider Portal and experienced contact center-based teams that are enabled by our business platform.

Our pioneering spirit and dedication to improve health care continue to produce significant industry-first advancements, quality recognition achievements, and high user satisfaction rates. AIM is certified by the National Committee for Quality Assurance (NCQA) and has received full accreditation for Health Utilization Management from the Utilization Review Accreditation Commission (URAC.)Position Description:

The Associate Medical Director supports the clinical integrity of the AIM solution to which he or she is assigned, making sure the program improves the appropriateness of care, improves patient outcomes and reduces cost. The Associate Medical Director supports the clinical development of the solution, including the overall strategic approach, program design, and clinical underpinnings (clinical evidenced based guidelines that are the foundation for the interventions which will be made by AIM on behalf of its clients.) The Associate Medical Director contributes to program innovation and evolution over time to increase efficiency and impact.

The Associate Medical Director participates in sales meetings with prospective clients (including preparation, value estimate assessment and, input on the characteristics of the local medical market) as one of the program/solutions clinical experts. This will also include meetings with prospects’ clinical leadership to ensure they understand the clinical basis for the solution. The Associate Medical Director supports the completion of RFIs and RFPs and other sales activities as needed to support the growth in (membership and revenue) of the solution.

The Associate Medical Director supports client implementations and is a key member of the team supporting the client and in particular the client’s clinical leadership after implementation. This includes

developing provider acceptance and support, answering clinical questions regarding the program, participating in conversations with the client’s key provider partners, as well as state specialty societies and other medical organizations and institutions.

The Associate Medical Director acts as one of the key clinical leaders supporting the call center clinical teams with respect to his or her solution. He or she is also involved in evaluating the solutions performance regarding impact and helping to analyze expected versus actual and the causes for any discrepancies. This includes synthesizing feedback from providers received directly, through the call center and through our clients to identify opportunities for improvement from an ease of use perspective and from and impact perspective.

Responsibilities:

Primary duties may include but are not limited to:

Provide the clinical expertise necessary to assist in the creation and support of a clinical, evidenced based program to improve appropriateness of care and reduce cost in a specified clinical domain

Work collaboratively alongside the Medical Director 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 with sales and client management activities as needed and be a clinical resource for them as well as our clients

Participate as a member of the Clinical Solution Strategy, Development and Support (CSSDS) team supporting the other members in their efforts and activities as possible

Monitor competitors’ products, emerging companies and technologies as sources of ideas for innovation and improvement.

Collaborate with others to continually drive innovation and improvement that support greater value and ease of implementation and use.

Stay abreast of clinical developments and advances in the specific domain and ensure that as appropriate they are incorporated into AIM’s solution.

Ability to represent the public face of the solution by interacting with professional societies, patient advocacy groups, government agencies, and the press and lay public as needed in collaboration with AIM marketing and communications.

Qualifications Qualifications:

Medical Doctor currently licensed and board certified in the solution domain

A minimum of 5 years of relevant clinical experience. Utilization management, case management, utilization review, or health care management experience helpful but not required

Experience in clinical coding (ICD-10, CPT, etc.), experience in medical informatics, and EMR experience all helpful but not required.

Demonstrated ability to work collaboratively with other clinicians and non-clinicians

Demonstrated experience and effectiveness in motivating 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 a manner consistent with job functions. Prepare clear and concise reports, correspondence, thought leadership pieces and other written materials.

Demonstrated ability to deliver effective presentations to all size groups

REQNUMBER: PS39382

Vacancy expired!


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