Anthem is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler. Through its affiliated companies, Anthem serves more than 107 million people, including more than 43 million within its family of health plans. We aim to be the most innovative, valuable and inclusive partner. For more information, please visit www.antheminc.com or follow @AnthemInc on Twitter.

  • One in eight Americans receives coverage for their medical care through Anthem's affiliated plans.
  • We offer a broad range of medical and specialty products.
Nov 04, 2021
Physician
Anthem Remote
SHIFT: Day Job SCHEDULE: Full-time We are currently seeking a versatile Board Certified Physicians to participate in pre-authorization reviews of high-tech diagnostic imaging, cardiac testing and sleep management services. Medical Directors in Clinical Operations determine the medical necessity of outpatient radiology, cardiology and sleep management requests using clinical guidelines and health plan medical policy. Location: Remote, anywhere in US Successful candidates will: Perform physician-level case review, following initial nurse review, of high-tech diagnostic imaging. Imaging modalities include CT, CTA, MRI, MRA, PET, and Nuclear Cardiology. Determine medical necessity of requests using AIM Medical Necessity Guidelines and client-specific health plan medical policy. Conduct peer-to-peer discussions with ordering physicians, physician assistants, and nurse practitioners to provide education regarding established guidelines and accepted standards of care as...