• Provide high level oversight, leadership and direction for one or more defined medical areas or functions.
• Interpret, recommend and review corporate policy within recognized area of responsibility.
• Refine conceptual framework and provide broad strategic direction.
• Develop and approve strategic and operational plans for assigned units or area of responsibility.
• Impact the performance of BCBSM including short term as well as long term effects on major business units.
• Other duties as assigned.

"Qualifications"

• Doctorate from an accredited school of medicine (M.D.) or osteopathy (D.O.) required.
• Ten (10) year's recent clinical experience in area of specialization plus utilization review experience.
• Current unrestricted state of Michigan doctor of medicine (M.D.) or doctor of osteopathy (D.O.) license.
• Board certified or board eligible and working towards certification in a specialty approved by the American
• Board of Medical Specialists or the American Board of Osteopathy.
• Certification in Utilization Review preferred.
• Knowledge of BCBSM, providers, services and facilities.
• Strong teaching and communication skills.
• Other related skills and/or abilities may be required to perform this job.

Department Summary / Preferences:

1) Use an analytic, data driven approach combined with clinical knowledge/experience to help assess and define areas of opportunity for continued strategic evolution for the purpose of impacting cost of care and medical appropriateness of care. 

2) Partner with the IMPACT team to support evaluation of various areas of medicine ( radiology, GI, etc.) in examining and sizing opportunities and looking at various strategies and approaches ( ie: UM, payment policy, medical policy, network strategies) – ensuring alignment across the approach holistically. May also entail examining traditional vendors and vendor/providers as part of overall strategy. 

3) Work across the enterprise to collaborate with leaders for medical and network management, partnering with network providers across specialties to better understand areas of opportunity will also be critical component of developing future strategies. 

4) Act as critical medical leader for external providers and plan sponsors, including regulatory & accrediting agencies, and healthcare community in general.

5) Lead efforts for improving and maintaining positive relations with providers, facilities, customers and consultants; supports sales and marketing efforts including participation in key marketing activities and presentations.