28 days old
2018-03-262018-04-23

Medical Director - Birmingham, AL

Solomon Page Group
Birmingham, Alabama 35244
  • Job Code
    37965
  • Job Type
    Employee
  • Job Status
    Full Time

Medical Director,
Blue Cross/Blue Shield of Alabama

Company Overview

Blue Cross/Blue Shield of Alabama is a regionally leading managed healthcare organization that is also a national leader in providing administrative healthcare services to some of the country's largest companies. BCBSAL covers over 3 million members, including 2.1 million members in Alabama and 920,000 out-of-state. Nearly 20,000 employers and thousands of individuals, count on Blue Cross Blue/Shield of Alabama to administer their health, dental and pharmacy programs.

Position Overview

Working in a team environment, the Medical Director provides clinical leadership and assists with new program development, implementation strategies and maintenance of clinical/quality programs. In addition, the incumbent develops and maintains employer and network provider relations in support of the corporation and BCBSAL membership. The Medical Director is expected to apply clinical and business acumen to ensure success of functional and corporate objectives and provides leadership through experience and training in the medical profession.

There are presently two Medical Director opportunities available: Case Management emphasis and Sales Support emphasis.

Qualifications:

  • Graduation from medical school with applicable specialty Board Certification in medical practice/current unrestricted license and post-graduate experience in direct patient care
  • Demonstrated knowledge and skills to perform clinical oversight for services such as precertification, preauthorization, appeals, clinical criteria review and updates, credentialing, medical policy review and consultation with internal and external providers; prior relevant applicable experience preferred
  • Ability to maintain current knowledge of Utilization Management and Case Management principles and standards
  • Ability to design and execute clinical strategies for the organization based on population data
  • Experience maintaining collaborative business relationships
  • Experience influencing, negotiating and directing provider partners and internal teams
  • Demonstrated experience making decisions and recommendations in a fast-paced environment

Please note: administrative or managed care experience IS NOT REQUIRED (but is a plus).

Send CV's to Jennifer Crutchlow's email: jcrutchlow@solomonpage.com

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Medical Director - Birmingham, AL

Solomon Page Group
Birmingham, Alabama 35244

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Medical Director - Birmingham, AL

Solomon Page Group
Birmingham, Alabama

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