Since 1933, Blue Cross and Blue Shield of North Carolina has offered its customers high quality health insurance at a competitive price and has led the charge toward better health and more consumer-focused health care in the state. Blue Cross and Blue Shield of North Carolina serves more than 3.8 million members and employs more than 4,700 North Carolinians, offering commercial, self-insured, and individual exchange products, with a 3.5 STAR rated Medicare Advantage program.
This position will be located in Durham, North Carolina, best known as part of the North Carolina Research Triangle. A national leader in medical research and health care, especially at Research Triangle Park, Durham also houses academic powerhouse Duke University, landing it a spot on Livability’s Top 10 College Towns. Durham is also home to art museums, a strong music culture, historic districts, with an enviable 2.5 hour drive to either beach or mountains.
Reporting to the Chief Medical Officer, the Vice President, Clinical Operations and Innovation will drive value-based care transformation with health systems and lead redesign of the clinical operations approach. This role will execute a statewide value-based strategy, establishing strategic plans for value-based care migration, coalescing internal experts in clinical, financial/actuarial, insurance operations, benefit design, information technology, and physician alignment to drive transformational success.
The ideal candidate will offer:
- Advanced clinical degree, MD, DO, or BSN with master’s degree; eligible to obtain a license in North Carolina.
- Five to 10 years of experience working in managed care, health system strategy, population health, accountable care, or a risk-based reimbursement environment.
- Ability to foster innovation and thought-leadership; exemplary written and interpersonal communication skills.
- Prior experience breaking down barriers, aligning incentives and powering new models of care delivery resulting in meaningful alignment between providers, payers, physicians and patients.
- Demonstrated team management experience, ability to mentor staff to achieve professional growth and success.
- Proven ability to conceptualize, develop, and lead efforts to support change within large, complex healthcare entities.
- Experience partnering with external vendors and stakeholders to reach a shared vision.