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Chief Medical Officer

Company: Blue Cross Blue Shield Of North Dakota
Location: Fargo
Posted on: August 17, 2019

Job Description:

Job Summary
The Chief Medical Officer is responsible for providing strategic leadership and serves as a medical expert for Blue Cross Blue Shield of North Dakota (BCBSND). This position has overall responsibility and accountability for advising the strategic direction of clinical integration, quality management, and health cost management. The Chief Medical officer oversees the development and maintenance of medical policy and other medical guidelines affecting members. Proactively identifies, evaluates and advances innovative solutions and strategies surrounding progressive approaches to healthcare delivery that enhance the patient experience, improve quality and reduce unnecessary medical expenditures.
Essential Functions

  • Directs, leads and oversees staff in accomplishing work objectives within the unit(s). Coaches, motivates, rewards and recognizes subordinates. Sets clear goals, objectives and performance expectations and holds employees accountable for achieving results.
  • Provides strategic leadership by combining business acumen and clinical credibility to bridge the gap between administrative and subject matter expertise for effective execution of critical programs.
  • Effectively collaborate with other internal functional areas such as Medical Management Network, Healthcare Analytics and Marketing in developing, monitoring and continually evolving healthcare programs that focus on enhancing the patient experience, improving quality and reducing unnecessary medical expenditures.
  • Reviews and determines medical necessity and appropriateness for pre-authorizations, prior approvals, referrals and diagnosis-related group (DRG) validation.
  • Oversees the development and implementation of clinical guidelines, protocols and care pathways.
  • Optimizes healthcare data and metrics to identify opportunities to drive improvements in healthcare delivery.
  • Represents BCBSND to clients, health systems and other external customers in areas of clinical, quality and healthcare services.
  • Assesses the effectiveness of quality improvement efforts designed to improve clinical performance, making recommendations to address healthcare costs and care initiatives.
  • Promotes information sharing, benchmarking, clinical innovation, and best demonstrated practice identification.Knowledge, Skills and Abilities Strategic Focus

    Advanced Specialized Technical Skills

    Advanced Medical Review Expertise

    Advanced Consultative/Advisory Approach to Clients

    Advanced Communication (Verbal/Written)

    Advanced Quality Focus


    Education Requirements Required: Doctorate

    Preferred: Doctorate Field(s) of Study: Doctor of Medicine Degree.
    Experience Requirements
    Required: Minimum of 10 Years

    Preferred: Minimum of 12 Years Experience Details: Minimum of 10 years of clinical experience, preferably with a general medicine field (e.g. Internist, Family Medicine, Pediatrician) or General Surgeon and 7 years of business development experience. Certification, Licensures& Registration Requirements Title: Current, unrestricted MD or DO License in the state of North Dakota (ND) State or Agency: Board certification by a medical specialty board approved by the American Board of Medical Specialties or the American Osteopathic Association
    Active credentials will need to be verified prior to hire or transfer into this position, and incumbent's license will need to remain active and in good standing while employed in the role.

    Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

    Other Information

    Job Posting Policy 6.05

    New employees with Blue Cross Blue Shield of North Dakota will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply.

    Equal Opportunity Employment

    Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

    For questions, please emailcareers@bcbsnd.com

    This job posting will be closed 8/30/2019 at 8:00AM CST. No further applications will be considered

Keywords: Blue Cross Blue Shield Of North Dakota, Fargo , Chief Medical Officer, Executive , Fargo, North Dakota

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