Lead Medical Director, Healthcare Consulting Group Markets
Blue Cross Blue Shield of North Carolina
August 7, 2018
Durham, North Carolina
Full Time - Experienced
At Blue Cross NC we are committed to making the health care system in North Carolina better. To achieve this commitment we need people who can bring energy and passion to our sales and healthcare team, a commitment to our core values and a dedicated approach to managed care.
What we’re looking for:
Blue Cross NC is seeking a highly motivated Medical Director who can monitor and improve the level of care we provide and help reduce our operational costs over time. The ideal candidate will have Commercial experience. As the Lead Medical Director this person will be responsible for supporting ASO Sales team and ASO client specific work within care management. This person will serve as the expert Medical Director including customer- facing engagements effectively representing Blue Cross NC healthcare and provider network services and capabilities. Represents Blue Cross NC to other external groups as needed by the enterprise. Responsible for developing strategic partnerships with internal business partners and external clients. Responsible for the development, ongoing refinement and execution of the Care Management and Network sales strategy designed to compliment sales and marketing efforts to grow membership through new sales and increased retention.
What you’ll be doing:
Jointly develops with sales management the strategy and approach for engagement of employer clients on healthcare and network offerings to grow and retain membership. Develops and maintains the Enterprise network and healthcare value proposition, sales messaging, network and program specific detail and supporting results (metrics) to message and respond to both customer-directed and consultant-directed requests for information and proposals.
Responsible for the coordination, collection, compilation and presentation of proposal requests and responses for employers, consultants and other external audiences related to the Healthcare divisional services and offerings.
Obtains competitive intelligence and feedback directly from external stakeholders and provides information back throughout the enterprise to enhance our understanding of employer clients’ specific needs for health care and medical expense interventions in support of developing, coordinating and implementing employer group specific strategies and recommendations aimed at demonstrating high value to the customer and the marketplace.
Develops communication tools and messaging to leverage our brand and the value of Blue Cross NC health and wellness offerings with decision-makers working closely with those responsible for Blue Cross NC brand management.
Serves in a consultative capacity with the Blue Cross NC enterprise to provide market insight, develop strategy and serve to recruit potential pilot customers for new and innovative product and program offerings.
Represents Blue Cross NC to external audiences as needed, e.g. providers and community groups.
Analyzes client group illness burden, medical expense, and utilization trends as part of group specific population health management. Collaborates with sales support team and external clients to implement clinical programs that enhance health outcomes and cost effectiveness. Works within care management department to identify and manage high dollar/high risk members.
Provides leadership, vision, and consultation to various teams:
Determines team priorities to reflect the organization’s core values and deliverables.
Develops, coaches and motivates others to take actions that support and reflect the core values and desired future state.
Leads multidisciplinary clinical and consulting teams in support of client member health management. Teams may include Medical Directors or other clinical professionals involved in utilization and case management of client members.
Develops and manages departmental budgets
MD or DO
5 years of experience in healthcare clinical consulting, sales development and/or health plan consulting
5 years of experience leading people and/or large projects
MBA or equivalent degree, e.g. MHA, MPH strongly preferred
Significant leadership experience in a consulting or sales or healthcare management field.
Account management or customer relationship management experience a plus.
Utilization/case management as a health plan Medical Director
Clinical coding and/or experience in claims based data analysis
Excellent presentation and communication skills
Internal Number: RQ0003201
About Blue Cross Blue Shield of North Carolina
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina. 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.
Our company is a not-for-profit with headquarters in Durham and major operations in Winston-Salem and Fayetteville. In all we employ more than 4,500 North Carolinians and serve more than 3.7 million customers.
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.