Senior Medical Director

Blue Cross of IdahoBozeman, MT
9d$243,150 - $389,040Hybrid

About The Position

Shape the Future of Healthcare in Idaho and Beyond Blue Cross of Idaho is seeking a Senior Medical Director to provide strategic clinical leadership and drive innovation in medical management. This is an opportunity to influence healthcare delivery at scale, improve outcomes, and ensure cost-effective, high-quality care for our members. Why Join Us? Lead with Impact: Direct medical management strategy, utilization review, and quality initiatives that set national benchmarks. Collaborate at the Highest Level: Serve as a trusted liaison with physicians, hospitals, and healthcare partners to strengthen provider relationships and improve member experience. Drive Innovation: Develop and implement evidence-based clinical guidelines and programs that enhance outcomes while managing costs. Flexible Work Options: Enjoy a hybrid schedule at our Meridian, Idaho campus or explore fully remote opportunities within an agreed-upon location. #LI-Remote #LI-Hybrid

Requirements

  • Experience: 12+ years of clinical practice, to include leadership experience
  • Education: Doctorate Degree in Medicine
  • Residency or Fellowship in a residency program approved by the Accreditation Council for Graduate Medical Education (ACGME)
  • Licensure: Current, unrestricted medical license – either Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO)
  • Board Certification via the American Board of Medical Specialties (ABMS) or Specialty Board
  • Ability to obtain an Idaho Medical License

Nice To Haves

  • Managed care experience, utilization management expertise, and background in medical administration.

Responsibilities

  • Provide leadership and mentorship to medical directors and clinical teams, fostering professional growth and collaboration.
  • Guide medical policy development, utilization management, and quality improvement initiatives.
  • Partner with Healthcare Operations to optimize efficiency through data-driven strategies that reduce costs and improve care.
  • Represent Blue Cross of Idaho in professional organizations and act as a key voice in shaping healthcare policy and practice.
  • Participate in appeals, grievances, and vendor oversight to ensure compliance and quality standards.
  • Minimal shared weekend call coverage required.

Benefits

  • We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.
  • We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.
  • We believe in employee growth, which is why we offer training, tools and numerous resources to assist with professional development.
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