Since 1933, Blue Cross Blue Shield 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 Blue Shield 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.
Reporting to the Chief Medical Officer, the Vice President, Quality and Healthcare Delivery will lead performance improvement for all programs, including NCQA accreditation, HEDIS, Medicare Star ratings, and hospital quality ratings. With a focus on innovation in healthcare delivery, this position will serve as the executive sponsor for any investment or joint venture related to clinical care delivery. This role will serve as the voice of Blue Cross Blue Shield North Carolina at the state and national level to establish the organization’s reputation in quality, performance measurement, and delivery system transformation.
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.
The ideal candidate will offer:
- Medical degree, MD/DO, with MBA, MHA, MPH, MMM or other applicable master’s degree preferred;
- Five to ten years of experience leading strategic quality initiatives within a managed care plan, or health system with an accountable care or a risk-based reimbursement environment.
- Proven success advancing quality measures, inclusive of Medicare Stars, HEDIS, and NCQA.
- Ability to foster innovation and investments in new models of care and clinical delivery. Interpersonal engagement to champion, integrate, and align quality programs into new provider reimbursement models.
- Experience representing an organization to external stakeholders and providing national leadership in the field of quality measurement.