Executive Medical Director, Medical Affairs

at Blue Cross Blue Shield Association in Chicago, Illinois, United States

Job Description

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
Yes

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Blue Cross Blue Shield Association is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, disability, veteran status, genetic information or any other legally protected characteristics.