Medical Director, Line of Business

Company: Blue Shield of California
Location: El Dorado Hills
Posted on: May 27, 2025

Job Description:

Your Role The Medical Director, National Accounts position is dedicated to supporting the promotion of growth and increased market share of the National Accounts and the Administrative Services Only (ASO) business. This includes strategic clinical and healthcare cost management guidance for the existing Blue Shield of CA book of business. This position will report directly to the VP, CMO, Commercial Markets. This position provides clinical direction to the sales team and sales processes and interacts directly with employers and consultants. This role will be at the center of driving strategy for how to reduce cost of care, while providing client advisory services, increasing engagement, and improving the quality of care & population health for our employers' membership. Your Work In this role, you will:

• Lead client and producer facing activities including finalist presentations and account services meetings, broker and consultant meetings, meetings with Mercer, WTW, Aon, etc. Actively participate in and guide the preparations and the actual client meetings. Other activities include interpreting clinical data for employers at regular or pre-determined intervals, reviewing cost/spending trends, making recommendations on improving member engagement and population health. You will work diligently both internally and externally to develop, refine, and expertly communicate the BSC Clinical Value Proposition.
• Work collaboratively with other Healthcare Solutions and BSC staff to quickly resolve client service issues, with particular emphasis on clinical issues. Be available to talk with key account members about their issues and the solutions.
• Act as a strategic thought-partner for key clients (e.g. UC, Stanford, CalPERS) who want best-in-class medical, health and wellness programs.
• Responsible for the planning, development, and leading the delivery of Healthcare Solutions related materials to clients, producers and business associations that describe and explain the operational details and value of Healthcare Solutions capabilities, services and programs. Includes working with the Health Data Reporting teams to analyze data trends and develop external customer reports.
• Support other ASO Line of Business activities such as: business planning, business development, and designing and implementing innovations to address market needs. Your Knowledge and Experience
  • Medical Degree (M.D./D.O.)
  • Completed residency preferably in adult based primary care specialty (e.g. internal medicine, family practice)
  • Active, unrestricted California State Medical License
  • Minimum 10 years managed care experience required
  • At least five years clinical experience required
  • Experience with California managed care marketplace is required
  • Previous experience in national, complex account management support is required
  • Experience supporting Administrative Services Only (ASO) lines of business is preferred
  • Previous experience in a similar sales role preferred
  • Prior experience as a people manager preferred
  • Excellent verbal and written communication skills, including ability to speak comfortably and extemporaneously to diverse audiences
  • Ability to explain program, clinical, operational, and quantitative information in a business-like, clear, coherent, and comprehensible way
  • Strong quantitative and analytic skills working with claims, operational, and clinical data and reports
  • Excellent interpersonal communication skills, including active listening, self-management and awareness, emotional intelligence, and ability to flex interpersonal style situational
  • Demonstrated ability to model a collaborative approach with internal and external stakeholders
  • Strong negotiation and creative problem-solving skills
  • Strong skills with Microsoft Office Suite, including PowerPoint, Excel, Word and Outlook

Keywords: Blue Shield of California, Berkeley , Medical Director, Line of Business, Executive , El Dorado Hills, California