Associate Medical Director

About the Role

The Medical Director brings a unique set of knowledge and skills to Blue Cross North Carolina, serving as an interface between the company and physicians, providers, employer and community groups, and members. This role utilizes clinical knowledge and experience to support value-based strategies, clinical operations, and the organizational pursuit of high-quality, cost-effective care for members. Responsibilities vary across the Health Care division based on the focus areas of the supported business unit.

Responsibilities

• Strategy: Develops, collaborates on, or drives strategy and approach for varied Health Care and organizational initiatives (e.g., sales management strategies, behavioral health strategies, new healthcare delivery strategies).
• Operations:
  • Medical reimbursement and policy
  • Care management (utilization management, case management, prior authorization, appeals)
  • Healthcare programs (disease management, Moonshots)
  • Network support (credentialing)
  • Quality model design and analysis
• Partnership:
  • Develop strategic partnerships with internal and external clients to support value-based agreements and improve consumer and provider experience.
  • Lead outreach and relationship-building across the community (e.g., providers, health systems, community partners, members).
  • Evaluate and manage new and existing vendors and solution partners to align with BCNC’s strategic direction.
  • Engage in ongoing provider engagement functions.
• Data Analysis:
  • Gather, manage, and analyze clinical and other data to identify opportunities for improving health outcomes and financial performance.
  • Discuss data and performance with providers, employers, accreditors, and regulators as needed.
• Communications:
  • Represent BCNC through presentations, speaking engagements, and leadership of advisory groups with external audiences related to healthcare transformation and BCNC’s initiatives.
  • Publish high-impact content focused on improving accessibility, quality, and affordability.
• Innovation:
  • Design payment models.
  • Identify market trends influencing key investments (e.g., new technologies, best practices).
  • Evaluate investment and partnership opportunities.

Requirements

• MD or DO from an accredited medical school and completion of a residency training program.
• 5+ years of experience in a related field.
• Current North Carolina medical license required or ability to obtain after hire.
• Board certification in an ABMS/AOA-recognized clinical specialty is required.

Pay

Base salary range: $191,153.00 - $305,845.00. Starting salaries are typically planned near the middle of the range and are determined by factors including experience, training, specialized skill sets, licensure, certifications, and business needs. This role includes a robust Total Rewards package featuring an annual incentive bonus (based on corporate goal achievement and individual performance), 401(k) with employer match, paid time off (PTO), and competitive health benefits and wellness programs.