Overview

Provides Office of Clinical Affairs and BCBSA with clinical leadership across multiple disciplines including clinical quality management, provider recognition, medical policy, innovations of service delivery, and strategic market opportunities. Ensures OCA and BCBSA business objectives incorporate clinical guidance to enhance business objectives that drive market value and maintains BCBS System leadership with members, providers, and stakeholders.

Builds and maintain effective relationship management with government agencies, accounts, and key business entities for Plans. Provides clinical support to the Chief Clinical Transformation Officer and Vice President, Clinical Operations. Provides leadership to Medical Affairs, Medical Policy Services and Clinical Quality Management. Collaborates with internal stakeholders to advance key systemwide, BCBS Plans or OCA initiatives and programs.

Responsibilities

Responsibilities include but are not limited to:

• Relationship Management in Office of Clinical Affairs (OCA) - Identify and maintain strategic relationships with external stakeholders that are essential to achieving strategic objectives for BCBSA. Develop and effectively manage internal and external customers and networks that are essential to establishing the leadership role of BCBSA with Plans.
• Operational Management in Office of Clinical Affairs (OCA) - In collaboration with the SVP/CCTO and VP of OCA, develop and implement strategic objectives of the Office of Clinical Affairs that align with the business needs of BCBS Plans and market demands. Provides leadership to Medical Affairs, Medical Policy Services and Clinical Quality Management and ensure alignment with the strategic direction of BCBSA and OCA. Provides advise in the effective deployment of BCBSA programs, products and services that impact healthcare quality, safety and value.
• Performance Management - Oversees OCA performance measurement goals related to the responsibilities for the VP, Medical Affairs On-going Financial Management -Oversees OCA financial performance to meet fiduciary responsibilities related to the VP, Medical Affairs

Qualifications

Required Basic Qualifications:

• Required Medical Degree (MD or DO)
• 15+ years of progressive healthcare experience developing and aligning operational goals and objectives. This experience should also include conducting research, evaluating quality performance, or implementation of organizational behavior or organizational culture.
• Minimum 5 years of management experience including managing staff, budget and leading performance improvements efforts.
• Minimum of 4 years of project leadership experience of value-based healthcare activities.

Preferred Basic Qualifications:

• Experience working with payers, regulatory agencies, and accreditation organizations
• Experience working with device or pharmacy companies, physician specialty organizations

Equal Opportunity Employer

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.