BCBSNE

Medicare Medical Director

Omaha, NE · Director

Sponsorship not specifiedDetected 14 days ago

Patient Care

About the role

Our team is the power behind that promise.
Candidates applying to this position must live within driving distance of the Omaha, Nebraska metro.
This position will require 2-3 days per week in the office.

Collaborate with key organizational partners and their teams to optimize quality and clinical initiatives and drive improvements across the Medicare population.
Develop and maintain strategic relationships with internal and external stakeholders involved with the care and management of the Medicare population
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there's no greater time for forward-thinking professionals like you to join us in delivering on it!
Team Blue, you'll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

Experience with utilization review/quality assurance, and direct case management.
To be considered for this position, you must have:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed are representative of the knowledge, skill, and or ability required.

preferred residency in an adult primary care specialty (family medicine, general internal medicine, geriatric medicine, combined internal medicine/peds)
Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.
Additional Training: preferred residency in an adult primary care specialty (family medicine, general internal medicine, geriatric medicine, combined internal medicine/peds)

At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.
The Medicare Medical Director is responsible for clinical, quality, care management, population health outcomes and cost for the Medicare population.
Oversight of clinical, quality, care management, and population health outcomes and cost for the Medicare population.
Lead clinical engagement in assigned market(s), partnering with the Chief Medical Officer to drive quality and care management performance improvement in primary and specialty care settings
Act as lead business and clinical liaison to network providers and facilities to support the effective execution of Medicare medical services programs
Seven (7) years of direct clinical (patient care) experience, with consideration given to quality improvement activities, participation in cost containment initiatives and other population health experiences.
An equivalent combination of education and experience may be substituted for this requirement.

The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.
We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.

This listing is sourced directly from BCBSNE's careers page and normalized into a canonical job model.