Medical Director Operations
20 hours ago
We are seeking a highly skilled Medical Director Operations to join our team at Blue Shield of California. As a key member of our Medical Management team, you will play a critical role in ensuring that our organization is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based healthcare system in California.
Key Responsibilities- Deliver and collaborate on clinical review activities, including management of physician processes in support of utilization management and transactional functions for CalPERS membership.
- Facilitate performance management and goals in alignment with organizational goals for the CalPERS membership.
- Lead or meaningfully contribute to Blue Shield priorities and transformative initiatives that continue to improve the health and wellbeing of Blue Shield of California CalPERS members.
- Provide direction and leadership in compliance with regulatory requirements and key operational metrics.
- A Medical degree (M.D./D.O.) and 12 years' experience, including a minimum of 5 years' experience in active clinical practice in an adult-based primary care specialty (internal Medicine or Family Practice).
- Unrestricted California State Medical License required.
- Board Certification in one of ABMS categories, preferably Internal Medicine, required.
- 5 years' experience in managed care that can contribute to utilization management, case management, and/or quality improvement activities or other healthcare administrative operations at the IPA or health plan level preferred.
At Blue Shield of California, we offer a competitive salary and benefits package, as well as opportunities for professional growth and development. We are committed to creating a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve.
We are an equal opportunity employer and welcome applications from diverse candidates. Please note that this role is based in California and requires a valid California State Medical License.
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Medical Director Operations
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Medical Director Operations
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Rancho Cordova, California, United States Blue Shield of California Full timeJob SummaryWe are seeking a highly skilled Medical Director to lead our CalPERS operations team. As a key member of our Medical Management team, you will be responsible for delivering and collaborating on clinical review activities, including management of physician processes in support of utilization management and transactional functions for CalPERS...
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Medical Director, Operations
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Medical Director Operations
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