Independence Blue Cross · 1 hour ago
SVP Health Services & CMO
Philadelphia, Pennsylvania
Full-time
Onsite
Mid, Senior Level
5+ years expIndependence Blue Cross is seeking a Senior Vice President Health Services and Chief Medical Officer to develop and implement a leading Health Services strategy for their Commercial and Medicare Advantage products. This role is responsible for provider contracting, policy development, and managing various health programs to improve health outcomes and member experiences.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Responsible for contributing to development, maintenance and communication of the corporate mission, vision, and values, and the corporate strategy both internally and externally
Accountable for development, implementation and maintenance of the Health Services strategic imperatives that align with and support achievement of the corporate strategy
Accountable to negotiate, execute and monitor performance of provider and vendor contracts, including value-based contracts where applicable, in collaboration with Actuarial, Underwriting and Sales to achieve strategic imperatives related to value, affordability and total cost of care
Accountable for development, implementation and maintenance of market leading utilization management, case and condition management, population health, clinical care transformation, quality management and provider engagement programs that are compliant with applicable federal and State statutes and regulations and Accreditation requirements
Accountable for development, implementation and maintenance of medical, pharmacy and claims payment policies and associated processes and procedures, including engagement of appropriate experts as required from time to time
Accountable for supporting the health value optimization program and working across all involved divisions to monitor medical cost and utilization trends and identify medical cost improvement opportunities and to take the necessary actions to implement new programs and interventions to address these in support of achieving strategic goals
Accountable to ensure ongoing analysis of unit cost, utilization, medical cost and health outcomes data by market segment, and to support cross-functional development and implementation of interventions and programs, internal or outsourced, that optimize utilization, cost of services, access to and coordination of care delivery, overall health outcomes, and performance on Stars, to achieve strategic goals
Develops constructive and collaborative working relationships with colleagues, providers, brokers, group customers, legislators, and regulators
Accountable to manage the divisional administrative budget to ensure Independence achieves its annual and strategic operating plan
Accountable to oversee the recruitment, development, training and retention of high potential human capital, and maintenance of a healthy work environment to maximize the operating performance of Independence
Accountable to cascade goals that align with the corporate and divisional strategy and drive optimal performance through the division annually
Accountable for annual performance evaluations of direct reports and assurance that same occurs through Health Services division
Qualification
Required
Minimum of college and medical school/osteopathic school
Must possess current, active, applicable state license to practice. This license must not be subject to probation, proctoring requirements or other disciplinary action, to practice his/her specialty in each state where the practitioner is licensed, and additional certifications where required, to practice his/her profession and specialty
In good standing with Medicare, Medicaid and Federal DEA programs
Minimum of five years of management experience with responsibility for oversight of health services in a leadership role
Preferred
Specialty Training and Board Certification: Completion of a residency in an American Board of Medical Specialties (ABMS) approved specialty is preferred. Current Board Certification in an ABMS specialty is a requirement if it possible under the regulations of the individual certifying board as some specialty boards require active clinical practice as a pre-requisite for ongoing re-certification
Experience in HMO and PPO settings preferred
Managerial experience, including administrative budget accountability, of 5 years preferred
Company
Independence Blue Cross
The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross.
5001-10000 employees
H1B Sponsorship
Independence Blue Cross has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (16)
2024 (2)
2023 (6)
2022 (2)
2021 (6)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Alexandra Jorgensen
Senior Vice President Human Resources
Joe Geist
SVP & Market President, National
Recent News
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2026-01-14
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