Janet McCauley, MD
Senior Medical Director
Blue Cross Blue Shield of North Carolina
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Dr. McCauley is a board certified obstetrician-gynecologist with over fifteen years of clinical experience in private practice. She is currently a Senior Medical Director in Medical and Reimbursement Policy at Blue Cross Blue Shield of North Carolina, where she serves as clinical lead for development and implementation of medical and payment policy, and supervises the medical director team in the utilization management and appeals departments. She also serves as Assistant Consulting Professor in the Department of Obstetrics and Gynecology at Duke University Medical School, where she precepts residents and medical students in ambulatory obstetrics-gynecology and principles of correct coding.
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Prior to her work at Blue Cross Blue Shield of North Carolina, Dr. McCauley worked as a Medical Director at Wellpoint and Cigna, and was a Visiting Fellow in Health Policy at the King’s Fund, London, UK.
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A North Carolina native, Dr. McCauley completed her undergraduate education at the University of North Carolina at Chapel Hill, received her medical degree from Duke University School of Medicine, and completed a Masters in Health Administration at the University of North Carolina at Chapel Hill School of Public Health. She completed residency training in obstetrics and gynecology at Eastern Virginia Graduate School of Medicine in Norfolk, VA, and subsequently entered private practice in the Tidewater Virginia area. She is also a Certified Professional Coder (CPC) and member of the American Academy of Professional Coders.
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Dr. McCauley has served the American College of Obstetricians and Gynecologists in numerous roles, including membership on the Committee on Practice Management, the Ad Hoc Subcommittee on Quality Measurement Planning, Vice Chair of the Committee on Coding and Nomenclature, Co-Chair of the Women’s Medical Home Work Group, member of the Well-Woman Task Force, participant in the “ReVITALize” Gynecology Data Definitions initiative, and Chair of the Ad Hoc Selection Committee for the ACOG/Merck & Co. Inc. Research Award on Immunization.
