Sr. Medical Director, Clinical Strategy

Your Role

Reporting to the Chief Medical Officer, the Senior Medical Director, Clinical Strategy will define the vision and priorities for Blue Shield of California’s strategy to deliver best in class clinical outcomes for our members while working to ensure that health care is affordable. In this role you will be accountable for working in partnership with other leaders to deliver best in class clinical programs and align our value-based care models to meet our clinical strategy objectives.

Your Work

In this role, you will:

Develop a clinical strategy framework and guiding principles, grounded in data on population health outcomes and cost, to deliver Best in Class clinical outcomes for Blue Shield of California members

Define the organization’s overall clinical strategy, as relates to priorities, partnerships, and key measures of success to improve member experience, population health and affordability, inclusive of primary care and specialty care

Co-chair the Clinical Program Review and Governance Committee with the Chief Medical Officer to ensure that all clinical programs are delivering expected clinical and cost of care outcomes for our members

Work with teams performing vendor management to ensure that contracts include appropriate metrics to ensure programs are meeting operational targets to achieve clinical objectives

Collaborate with the Health Economics team to develop the methodology to evaluate the effectiveness and lead a process to ensure robust evaluation of all clinical programs

Collaborate with business leaders to ensure that the clinical strategy and clinical programs are meeting business, client, and member needs

Create an environment of accountability and continuous quality improvement to ensure that all clinical programs continue to meet and exceed objectives necessary to deliver best in class clinical outcomes for Blue Shield of California members

Communicate internally and externally the vision and strategy to transform healthcare to deliver Best in Class clinical outcomes for Blue Shield of California members

Your Knowledge and Experience

Minimum of 2 years of previous medical leadership experience

Minimum of 5 years of direct patient care experience post residency

Minimum 4 years experience in observational study design and execution and/or clinical program evaluation

Medical degree (M.D./D.O.)

Maintain active, unrestricted California State Medical License required; Maintain active, unrestricted Medical License in all additional assigned states required

Maintain Board Certification in one of ABMS, ABOS, or AOA recognized specialty required

Outstanding verbal and written communication skills

Ability to lead through influence in a matrixed organization

Masters or PhD in Health Services Research, Epidemiology, Biostatistics or similar field preferred

Experience in a health plan or managed care organization is preferred

Executive