|Director of Medical Management|
|# of Openings||1|
Accountable for activities and personnel related to Medical Policy, Clinical Policy and Utilization Management review. Provide strategic leadership and direction related to all aspects of medical policy, benefit interpretation, FAM updates and Plan education. This encompasses all functions related to delivering medical policy/benefit interpretation across all Plan products including Plan inquiries and subsequent education, FAM author of medical information/clarification/guidance and Plan inquiries and responses. Provides direction and leadership for multiple projects, services and associated deliverables of significant complexity and/or impact related to FEP Medical Policy/Benefit Delivery. Leads strategic cross-functional projects and teams developing project scope and requirements for proposed initiatives and Pilots, including outcome measures.
Responsibilities include but are not limited to:
Required Basic Qualifications:
Preferred Basic Qualifications:
Blue Cross Blue Shield Association is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, disability, veteran status, genetic information or any other legally protected characteristics.