Executive Medical Director, Medical Affairs - Chicago, IL, United States - Blue Cross Blue Shield Association

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    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.

    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.
    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.

    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.

    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.

    Medical license and board certification

    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

    Expert knowledge of medical cost and quality management especially Medicare Stars
    Knowledge of Plan policy implementation, claims operations and provider and account relations