Medical Director - Client Services and Analytics

Position Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

The Medical Director, Client Services and Analytics will provide a key leadership role in guiding the clinical sales and marketing strategy and execution of CBC’s Commercial Group lines of business. The position will partner with the sales team and with current and prospective clients by recommending strategies and solutions and providing guidance to maximize sales outcomes and communication of Capital’s clinical strategies and solutions.

Responsibilities and Qualifications

Partner with Commercial Group sales team(s) to educate key clients about the Company’s products, programs, strategies and goals. Emphasize the Company’s medical capabilities as a differentiator from competitors.

Monitors and drives patient and client experience/satisfaction metrics

Maintains and leverages relationships to drive market growth

Leads and promotes collaboration across multiple disciplines and teams to achieve clinical and business outcomes

Supports clients in the interpretation of data and provides consultation in developing strategies on behalf of the client

Provides strategic direction to Healthcare Delivery for the optimal delivery of program value narratives

Lead the evolution of Capital’s group clinical data consultation model

Lead the clinical growth and evolution of our comprehensive stop loss and high cost claimant strategy

Skills:

Ability to engage and build lasting relationships and collaborations with key clients

Ability to assess business needs, design and implement programs and evaluate results

Ability to distill complex medical terms, theories and analyses into understandable language

Knowledge:

Managed healthcare systems, quality assurance and improvement

Strong business acumen, including working knowledge of changing U.S. payer and provider landscape

Experience:

Minimum 5 years of experience working in a health care delivery system, insurer or managed care organization.

Five years clinical experience, post residency, including both inpatient and outpatient care.

Five years of experience in a management or leadership position in the health care industry.

Insurance product sales experience.

Education and Certifications:

MD or DO degree required

Current, unrestricted licensure in Pennsylvania as an MD or DO required

PA license to sell Health and Life Insurance required or must obtain license to sell within 90 days from date of hire. Continued education is required to maintain license.

Physical Demands:

While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work over 40 hours per week. The employee must occasionally lift and/or move up to 5 pounds.

Location:

This position is classified as hybrid, which requires onsite work Tuesdays and Wednesdays at our office in Harrisburg, PA.

About Us We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.