Associate Medical Director

Remote Flex - North Carolina

Remote Flex - Mississippi

Remote Flex - Louisiana

Remote Flex - South Carolina

Remote Flex - Kentucky

Remote Flex - Kansas

Remote Flex - Iowa

Remote Flex - Indiana

Remote Flex - Arkansas

Remote Flex - Texas

Remote Flex - Georgia

Remote Flex - Virginia

Remote Flex - Tennessee

Remote Flex - Pennsylvania

Remote Flex - Michigan

Remote Flex - Wyoming

Remote Flex - Wisconsin

Remote Flex - Idaho

Remote Flex - Utah

Remote Flex - Florida

Remote Flex - South Dakota

Remote Flex - Oklahoma

Remote Flex - Arizona

Remote Flex - Ohio

Remote Flex - Missouri

Remote Flex - Alabama

Full time

RQ0019455

Job Description

The Medical Director brings a unique set of knowledge and skills to the business of Blue Cross North Carolina and frequently serves as an interface between the company and physicians, providers, employer and community groups, and members as needed. Utilizes clinical knowledge and experience to support value-based strategies, clinical operations and our organizational pursuit of high quality and cost-effective care for members.

The application of a Medical Director’s knowledge and clinical skills will vary across the Health Care division, dependent on focus areas identified by the business area supported.

Leadership Skills:

• Project planning and management

Core Skills:

• Strategy

• Develops, collaborates and/or drives strategy and approach for varied Health Care and/or organizational initiatives (i.e. sales management strategies, behavioral health strategies, new health care delivery strategies)

• Operations

• Medical reimbursement and policy

• Care management (utilization management, case management, PA, appeals)

• Healthcare programs (disease management, Moonshots)

• Network support (Credentialing)

• Quality model design and analysis

• Partnership

• Develop strategic partnerships with internal business partners and external clients to support value-based agreements and drive better consumer and provider experience.

• Takes a lead role in outreach and relationship building across the community (i.e. providers, health systems, community partners, members, etc).

• Evaluate and manage new and/or existing vendors and solution partners to align to BCNC’s strategic direction

• Ongoing provider engagement functions

• Data gathering, management and analysis

• Evaluate clinical and other data to identify opportunities for improvement in health outcomes and financial performance

• Discuss data and performance with providers, employers, accreditors and regulators as needed.

• Communications

• Represent BCNC through delivery of presentations, speaking engagements and leadership of advisory groups with external audiences related to health care transformation and BCNC’s initiatives.

• Publish high impact content focused on improving accessibility, quality and affordability.

• Innovation

• Payment model design

• Identify market trends that should influence key investments (new technologies, best practices).

• Evaluation of investment/partnership opportunities

Hiring Requirements

• MD or DO from an accredited medical school and completion of residency training program.

• 5+ years of experience in related field

• Current North Carolina medical license

• Board certification in ABMS/AOA recognized clinical specialty is required

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$191,153.00 - $305,845.00

Skills

Clinical Experience, Clinical Leadership, Health Care, Health Care Compliance, Healthcare Development, Healthcare Improvement, Healthcare Management, Healthcare Transformation, Medical Care, Medical Decision Making, Medical Knowledge, Medical Quality, New Program Development, Patient Care, Patient Care Coordination, Patient Evaluations, Policy Development

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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC . If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected] .

About Us

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.

Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application, hiring process, or have technical issues that prevent you from completing your application please notify HR at [email protected] .

Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states:

Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming