The Executive Director supports strategic and operational leadership of the BCBSA Clinical Team, including support of the creation of the clinical operations strategy and delivery of value-added resources and tools.
This role provides clinical expertise and population health thought leadership in support of delivering more affordable and quality care for all members.
In addition, the Executive Director will implement innovative solutions that enable BCBS Plans to be proactive and that also enable industry leadership.
Plays an integral role in the development of a robust clinical product strategy that continuously builds and expands the clinical profile of the BCBS brand and generates sustained value in execution of deliverables.
Clinical Expertise
- Provide strategic insight and tactical direction to support cross functional clinical projects and initiatives that directly impact the BCBSA agenda, NorthStar and strategic pillars.
- Partnering with peer colleagues and cross-functional teams, to provide strategic medical direction to support the needs of the business (i.
e. Distinction Program and clinical quality in partnership and collaboration with other internal teams.
Provide internal and external education and expertise to support innovation and market adoption of best practices and new technologies in a variety of settings, including conferences, webinars, and site visits (as needed)
Clinical Process Optimization
- Responsible for the development of continuous improvement in standards of practices, process, and tool documentation.
- Collaborates cross-functionally on the development, management, maintenance of deliverables i.e., timelines, study plans, etc.
using rigorous data analysis and strong inter-personal influencing skills to make robust data driven decisions.
Contribute to the preparation and review of clinical program documents and other study related documents assuring quality and consistency.
Drives Financial Performance
- Manages within budget to forecast and strategic workforce planning.
- Strong understanding of the cost drivers, attuned to principles of clinical cost disciplined management.
- Proactive identification of potential risks and development / implementation of actions to avoid or mitigate and able to make the appropriate trade-offs of balancing risks with study deliverables and costs.
Leadership
Cultivates an inclusive environment of inter-professional collaboration and teamwork that recognizes and encourages professional and personal development.
Plan related responsibility
Interacts extensively with Plan Medical Directors, Plan Chief medical officers and clinical researchers and practitioners within BCBSA, the BCBS system, FEP and externally.
Specific contacts may include subject matter experts within healthcare, biomedical and biotechnology and government agencies.
Interacts with BCBSA and Plan Legal and government relations staff.
Education
- Required - MD; M.D. or D.O., Board certified and unencumbered license
- Masters Degree - M.P.H. or other advanced degree is desired
Certifications
Medical license and board certification
Experience :
- A minimum of 5 years health plan experience, as Medical Director or higher
- Experience in management of individuals with advanced training including MDs and / or PhDs
Skills
- Expert knowledge of medical cost and quality management especially Medicare Stars
- Knowledge of Plan policy implementation, claims operations and provider and account relations
- Highly skilled at working cross-functionally with key internal and external stakeholders
- Excellent written communication and presentation skills
People Management
LI HYBRID
Director, VeriCre (Hybrid)
The American Medical Association (AMA) is the nation's largest professional Association of physicians and a non-profit organization. As a Director, VeriCre, you will leadand oversee the strategy and expansion of the Credentialing Product Portfolio(CPP), including the launch of the newest Credentiali...
Medical Director - Kane County Jail
Viewing: Medical Director - Kane County Jail (Physician)Medical Director - Kane County Jail (Physician). As a Medical Director, you will be responsible for providing medical oversight and guidance in accordance with the security regulations of the company and the regulations of the institution to wh...
Site Medical Director
A Site Medical Director provides clinical and administrative leadership to Howard Brown Health Center and is responsible for the quality of care provided to participants in Primary Care at the assigned site, and for the clinical productivity of the medical provider clinical site staff. If medical ed...
Medical Director
The Medical Director is client-oriented, an excellent communicator, and a natural mentor to all members of their team. Clinic Manager and reports to the Regional Director of Operations to ensure the holistic success of their Clinic. Veterinary Medical Degree (DVM/VMD or foreign equivalent). Access t...
Medical Director (part-time, hybrid Illinois)
The Medical Director will provide the principal leadership and clinical expertise to operations on all medical aspects relating to the peer review process, utilization review activities, case management, and/or other activities requiring clinical leadership and consultation. Acentra seeks a Medical ...
Hematology/Oncology - Medical Director Opportunity
The Medical Director is responsible for building a robust general hematology and medical oncology program in Berwyn and surrounding communities. The Division of Hematology/Oncology at Loyola Medicine is seeking a Medical Director for the MacNeal Community Cancer Center located in Berwyn, Illinois. T...
Area Director, Medical Science Liaisons
Job Purpose:To manage the activities of the Medical Science Liaison (MSL) team to develop and implement strategies that: Optimally manage thought leader/academic institutions and other key health care provider/organization relationships, specifically with the provision of timely and up to dat...
Client Services Director - Medical Communications - Remote
Continuing their growth, the team are excited to bring on someone new to join their Director-level leadership team, in the form of an Client Services Director! As Client Service Director, you'll bring a wealth of experience in the medical communications industry, leading and driving multiple account...
Clinical Physician / Site Medical Director - MSHC - Main Clinic
Under the administrative direction of the CMO, the Site Medical Director along with clinic responsibilities include independently performing physical examinations for a broad range of clients to diagnose and treat diseases, injuries, and other disorders. The Site Medical Director is responsible for ...
Hematology/Oncology - Medical Director Opportunity
The Medical Director is responsible for building a robust general hematology and medical oncology program in Berwyn and surrounding communities. The Division of Hematology/Oncology at Loyola Medicine is seeking a Medical Director for the MacNeal Community Cancer Center located in Berwyn, Illinois. T...