Medical Director - National Accounts Integrated Health Model - 72065SY
WellPoint - St. Louis, MO

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WellPoint is one of the nation's leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are dedicated to improving the lives of the people we serve and the health of our communities. WellPoint strives to simplify the connection between health, care, and value for our customers.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

This position is located in St. Louis, MO.

Mercer Heath Advantage (MHA) Medical Director : Responsible for serving as the MHA Operational Medical Director. The medical director will be responsible for supporting the clinical vision and implementation in order to deliver an improvement in the health of the people we serve. The medical director supports product strategy/design and medical management approaches that impact health care quality, cost, and outcomes, and improving access to the health improvement tools offered to MHA members.

Day to day clinical responsibilities means that the medical director provides clinical oversight for Utilization Management, Case Management, and Disease Management of the MHA Clinical Team. Primary duties may include, but are not limited to: case reviews for both utilization and case management issues, consistent adoption and implementation of all medical policies, leading multidisciplinary rounds, peer to peer outreach for both UM and CM issues, identifying quality issues, clinical report reviews, trend management, benefit design consultation, and supporting overall clinical performance guarantee success.

The medical director provides clinical expertise in sales planning and participates in the acquisition and retention of clients for MHA as needed. Provides input on the clinical relevance of account reporting regarding use of medical services by MHA members. Involved in identifying and managing medical utilization trends and recommends medical management responses to MHA. Responsible for proactively identifying and solutioning with account management, emerging trends and market changes that impact the client and members.

WellPoint is one of the nation's leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are dedicated to improving the lives of the people we serve and the health of our communities. WellPoint strives to simplify the connection between health, care, and value for our customers.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

This position is located in St. Louis, MO.

Mercer Heath Advantage (MHA) Medical Director : Responsible for serving as the MHA Operational Medical Director. The medical director will be responsible for supporting the clinical vision and implementation in order to deliver an improvement in the health of the people we serve. The medical director supports product strategy/design and medical management approaches that impact health care quality, cost, and outcomes, and improving access to the health improvement tools offered to MHA members.

Day to day clinical responsibilities means that the medical director provides clinical oversight for Utilization Management, Case Management, and Disease Management of the MHA Clinical Team. Primary duties may include, but are not limited to: case reviews for both utilization and case management issues, consistent adoption and implementation of all medical policies, leading multidisciplinary rounds, peer to peer outreach for both UM and CM issues, identifying quality issues, clinical report reviews, trend management, benefit design consultation, and supporting overall clinical performance guarantee success.

The medical director provides clinical expertise in sales planning and participates in the acquisition and retention of clients for MHA as needed. Provides input on the clinical relevance of account reporting regarding use of medical services by MHA members. Involved in identifying and managing medical utilization trends and recommends medical management responses to MHA. Responsible for proactively identifying and solutioning with account management, emerging trends and market changes that impact the client and members.

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WellPoint, Inc. (WellPoint) is a health benefits company serving 35 million medical members, as of December 31, 2008. The Company is an...