Chief Medical Officer

4 weeks ago


Baltimore, Maryland, United States CareFirst BlueCross BlueShield Full time
Job Summary

CareFirst BlueCross BlueShield is seeking a highly skilled and experienced Chief Medical Officer to lead our healthcare leadership team. As a key member of our executive leadership, you will be responsible for providing strategic clinical direction for all programs promoting health equity, improved quality of care, and managing cost of care.

Key Responsibilities
  • Provide expert clinical consultation to executives throughout the organization.
  • Oversee and direct the rendering of medical management decisions at all levels of the health plan that maximize benefits for our members while pursuing and supporting corporate objectives and maintaining compliance with regulatory bodies.
  • Lead a team of clinical and non-clinical staff to manage the inpatient experience for CareFirst Members at hospitals in Maryland using a per diem methodology and at hospitals in the rest of the United States using a diagnostic related group (DRG) methodology.
  • Collaborate with other senior leaders on efforts that enhance the quality-of-care delivery, improve outcomes, and improve value delivered to our members and accounts.
Requirements
  • Medical Degree in primary care specialty from an accredited medical school and an American residency in a primary care specialty.
  • Current medical license in the State of Maryland (or credentials to apply for and be granted a Maryland license).
  • Board certification.
  • Minimum of 8 years clinical and administrative experience in a managed care setting.
  • Previous experience as medical director for a healthcare company.
  • At least 5 years as a leader of people and teams.
Preferred Qualifications
  • In-depth knowledge of Medicaid and Medicare related programs in a health plan/payor environment, with solid understanding of Stars and risk adjustment.
  • Prior experience with operations management.
  • Previous experience collaborating with formal health economics function within corporate environment.
  • Ability to expand in scope and clinical leadership oversight as business needs evolve.
What We Offer

CareFirst BlueCross BlueShield offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).


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