Medical Director, Arbitrations And Utilization Management (Part Time)

Blue Cross and Blue Shield Association

Oakland, CA
9 days ago

Highlights

We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. In this role, you will provide clinical review and support for provider arbitrations across Commercial and Medicare lines of business and provide flexible UM Medical Director coverage based on operational needs.

Numbers & Facts

Location	Oakland, CA
Industry	Insurance
Company Size	2,000 to 2,499 employees
Website	https://www.bcbs.com/about-us/careers

Description

Your Role

The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Arbitrations and UM MD Float is reporting to Sr. Medical Director, Arbitration/SIU/Mandates/Specialty Director Oversight. In this role, you will provide clinical review and support for provider arbitrations across Commercial and Medicare lines of business and provide flexible UM Medical Director coverage based on operational needs.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

This is a part-time position with a 0.6 FTE schedule

About Company

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.