Vice President, Chief Medical Officer - Physician Executive
Vice President, Chief Medical Officer - Physician Executive
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Salary Not Disclosed
1 Vacancy
Job Description
We take great strides to ensure our employees have the resources to live well be healthy continue learning develop skills grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
Job Summary/Position Purpose:
This position is responsible for developing and executing the companys strategy for improving health and affordability of care through leadership of the companys clinical operations. This role requires partnership with health plan leaders and enterprise provider network teams to provide oversight of quality improvement regulatory compliance and health affordability.
How You Contribute to the Companys Mission in this Role:
Provides strategy direction and oversight for all aspects of medical management medical policy development quality improvement population health and management of clinical delivery assets.
Collaborate with leadership and the board in the development and measurement of performance goals for quality cost growth people and innovation for all areas of responsibility.
Provides direction of the medical quality team and functions of the company. This includes managing staff ensuring there are qualified clinicians accountable to the organization for decisions affecting Louisiana Blue members developing strategies for quality improvement accreditation activity and compliance activity.
Directs total cost of care for all lines of business. This includes leading a multidisciplinary medical action function that coordinates and organizes corporate medical cost containment activities. It also includes oversight of required analysis of cost and utilization data that will drive improvement strategies.
Responsible for physician and provider outreach program development and implementation as it relates to medical management activities including provider advisory committees. Responsible for development maintenance and communication of the corporate medical policy.
Reviews annual operating objectives and plans for the clinical operational areas to ensure clinical quality patient safety and patient satisfaction.
Required Qualifications:
Doctor of Medicine (M.D.) with 10 years of experience in a senior management role in a health plan large provider organization or other health care entities required.
Current active unrestricted license to practice medicine in a State or Territory of the United States required.
Physician candidates should have the ability to obtain licensure in the state of Louisiana and must be Board Certified in a specialty recognized by the ABMS
Comprehensive knowledge of medical management UM QA physicians education UM data reporting pharmacy management including formularies and rebates.
Understands concepts of the development and implementation of medical policy.
Experience developing and leading teams and being a collaborative leader.
Demonstrated ability to establish trust and credibility at all levels of the organization and with a broad range of external stakeholders.
Strong knowledge of managed care industry and / Medicare experience.
The position requires availability for travel and extended hours.
Preferred Qualifications:
5 years of clinical practice experience.
5 years of Quality Management experience.
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.
- Perform other job-related duties as assigned within your scope of responsibilities.
- Job duties are performed in a normal and clean office environment with normal noise levels.
- Work is predominately done while standing or sitting.
- The ability to comprehend document calculate visualize and analyze are required.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME FIREFOX SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive only those most qualified will be contacted. To monitor the status of your application please visit the My Applications section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application please contact for assistance.
In support of our mission to improve the health and lives of Louisianians Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke and in order to promote good health our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration criminal courts federal state and county repositories of criminal records Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994 individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Required Experience:
Chief
Employment Type
Full-Time
