Job Description Summary
Responsible to BCBS Plan and other key stakeholders to provide clinical expertise and leadership for medical affairs strategy development and implementation. Serves as a thought and opinion leader to provide clinical leadership and support to internal and external strategic initiatives in support of BCBSA and BCBS Plans. Works collaboratively with other medical directors to provide consultative leaders to the development of evidence-based reference medical policy information. Designs and implements innovative solutions that enable BCBS Plans to be proactive and that also enable industry leadership.
Responsibilities include but are not limited to:
- Medical Affairs Leadership-Responsible to BCBS Plan and other key stakeholders to provide clinical expertise and leadership for medical affairs strategy
development and implementation. Serves as a thought and opinion leader to provide clinical leadership and support to internal and external strategic
initiatives in support of BCBSA and BCBS Plans. Provides clinical guidance and support to initiatives that address public health issues. Implements deliverables
in support of BCBSA Board strategies and OCA key initiatives.
- Reference Medical Consultation-Collaborates with other medical directors to provide consultative leader and direction to Medical Policy Service in the
development of evidence-based reference medical policy information.
- Communication Management-Publication: Manage and undertake process improvement for the internal communication on timelines, evidentiary review,
and deliverables. BCBSA Board Strategies: deliver the identified content in support of the BCBSA Board Strategies, including precision medicine and medical
- Ensure strong Thought Leader (TL) relationships; develop and nurture relationships with Key Opinion Leaders (KOLs) and consultants in the clinical
community in order to strengthen BCBSA's leadership position; serve as a professional representative of OCA in the healthcare community. Share
responsibility with Clinical Operations for decisions regarding the recruitment and retention of pharmaceutical, medical device, and diagnostic companies to
our Evidence Street subscriber platform portfolio, as well as new business opportunities and strategies for product/platform development.
Required Education, Certifications and Experience
- M.D. or D.O.
- A minimum of 5 years health plan experience, as Medical Director or Medical Consultant with responsibility
- Experience in representing Medical Affairs and Clinical Operations to consumers, businesses, providers and media
- Medical license
- Board Certification
- Demonstrated knowledge and experience of interaction of clinical operations with other Plan functions including but not limited to medical management, medical policy, legal, marketing, media, government relations, provider contracting etc.
- Knowledge of medical policy implementation, claims operations and provider and account relations
- Works effectively in cross functional teams
- Works effectively with Plan Medical Directors
- Written communication and presentation skills
Preferred Education, Certifications and Experience
- M.P.H. or other advanced degree is desired
People Management - No