Senior Medical Director

Blue Cross of Idaho•Meridian, ID

1d•Hybrid

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

12+ years of clinical practice, to include leadership experience
Doctorate Degree in Medicine
Residency or Fellowship in a residency program approved by the Accreditation Council for Graduate Medical Education (ACGME)
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.