Associate Medical Director

Associate Medical DirectorRooted in Wyoming! We are Blue Cross Blue Shield Wyoming: a not-for-profit health insurer with offices throughout the state. Ever since a small group of caring, persistent Wyoming women helped us put down roots in 1945, everything we do is aimed at better health care for the people of Wyoming.Our Vision: We envision a future where integrity, compassion, and trust define a local health insurance experience. Committed to doing the right thing for our members, employees, and community, we strive to protect and contribute to the health and care of all we serve.Our Mission: provide our members with access to local health insurance solutions that prioritize health, care, and well-being for those who call Wyoming home.An Associate Medical Director will be joining a dynamic experienced clinical team that provides quality health care as a health plan entity for the members of Blue Cross Blue Shield of Wyoming.Your core responsibilities include the aspects of utilization management as guided by medical policy for both medical and pharmacy benefits. Population Health is a new health plan endeavor that assists our members by case management, innovative health services, quality improvement projects and aspects of social determinants of health concerns. Our network of approved Wyoming licensed providers requires comprehensive credential reviews. An important expectation is to share your clinical expertise with a variety of departments at BCBS of Wyoming.Team collaboration begins with a strong working relationship with colleagues that comprise the Chief Medical Officer Department. You will be working closely with our nurse reviewers and clinical administrative staff. Inter-departmental interaction can include the provider network department, sales and marketing, data analytics and executive leadership. An understanding of our regulatory environment includes URAC Accreditation, legal compliance and Blue Cross Blue Shield Association governance. Our Clinical Quality Committee provides valuable input from our medical community.To be successful as an Associate Medical Director will require expansion of your physician skill set from a clinical base to a health plan concept. Evidence-based decisions will guide your application of medical policy to provide health care for our BCBS of Wyoming members. A greater proportion of your time will be focused on computer and information technology. Important interactions with the professional community exist with prior authorizations, peer-to-peer discussions and CME opportunities.Qualifications include a graduate education from a School of Medicine or School of Osteopathy as defined by national accreditation standards. You must have a current, active, unrestricted license as an MD or DO from the Wyoming State Board of Medicine and current clinical board certification with Maintenance of Certification. We ask that you have a minimum of five years post graduate clinical experience in direct patient care and a preference for those with administrative experience.Remote work is a consideration following completion of training. This position requires a greater proportion of time spent in the workplace to maximize collaborative working relationships. Blue Cross Blue Shield of Wyoming is an equal opportunity employer offering a robust benefits package. BCBS of Wyoming has recently been recognized as a certified "Great Place to Work!"BCBSWY Employees EnjoyBest-In-Class Health Insurance at minimal to no-cost for BCBSWY employees! PLUS many other benefits along with highly competitive compensation!Our compensation program is reviewed for competitive market match on an annual basis and employees are eligible for annual merit increases. Monthly incentives that are based on individual and company performance are also available to eligible employees and members of our Sales Team can realize generous performance-based commissions.At BCBSWY our employees are provided best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include medical, dental, vision, 401(k), life insurance, paid time off (PTO), 10 paid holidays in addition to PTO annually, plus 8 paid volunteer hours, various wellness programs, and a dress code of "Dress for Your Day!" which can mean jeans every day (depending on your role).Serving Those Who Call Wyoming HomeOur positions are all based in Wyoming. Depending on the department and the position, eligible employees may be offered limited In-Office/WFH flexibility (for those positions that are offered limited WFH, there will be a required number of In-Office days per week/month depending on department). Executive level employees are required to reside full-time in Wyoming.Our Selection ProcessTypically includes the following (NOTE: process steps may differ depending on role applied for)Review of your completed application and any additional submitted materials (e.g., cover letter, certifications, etc.) for minimum qualifications and skills alignment.Confirmation of Wyoming residency, intent to become a Wyoming resident, or reasonable commuter distance if Colorado resident.Recruiter Phone Screen.Possible Self-Assessment and/or Questionnaire.Initial interview with Hiring Manager.Possible 2nd Interview with Hiring Manager and/or additional Team members.Comprehensive Background Check.BCBSWY is an Equal Opportunity Employer. We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. Qualified applicants are provided with an equal opportunity and selection decisions are based on job-related factors.We use E-Verify to confirm employment eligibility; we DO NOT sponsor applicants for work visas.BCBSWY is committed to the full inclusion of all qualified individuals. As part of this commitment, we will ensure that persons with disabilities are provided reasonable accommodations for the application, selection, and hiring process. If reasonable accommodation is needed, please contact: View email address on click.appcast.io