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Chief Operating Officer

Company: 
BCBSA
City: 
US IL Chicago E. Randolph
Occupational fields: 
Management
Employment type: 
Full time
Remote Position: 
No
Required degree level: 
Other

The Blue Cross Blue Shield Association (BCBSA) is a national association with 33 independent, community-based, and locally operated Blue Cross and Blue Shield companies that serve 1 in 3 Americans. Blue Cross and Blue Shield companies are in nearly every ZIP code in the U.S., the District of Columbia and Puerto Rico, contracting with more than 2 million doctors and hospitals across the country.

By joining BCBSA, you can be part of an organization that builds on a unique, rich history in order to build an affordable, accessible, equitable system of health for the people we serve-no matter who they are or where they live. We are constantly evolving our culture and navigating an ever-changing industry to meet the needs of health care consumers today, and tomorrow.

Reporting to the Chief Executive Officer (CEO), this position is a critical member of our Executive Leadership Team who leads a business-oriented, transformative operations team that executes on core national programs and operations that support the local Blue Cross and Blue Shield companies. This results-oriented leader also provides the vision and direction for all technology functions within the businesses.

Job Responsibilities:

  • Strategy Development: Develops and executes a comprehensive strategy for all of BCBSA's program operations, transforming and connecting the networks and system of the Federal Employee Program (FEP) and National Programs and delivering an enhanced focus on National Accounts and Medicare Advantage operations in support of the collective success of the Blue System.
  • FEP Management: Oversees the P&L for all lines of FEP business (medical, Rx, dental & vision) to drive value for the 5.6 million federal employees and retirees who choose BCBS. Responsibilities include national pricing and benefit design, risk management strategies, care management/HEDIS oversight, member experience and communications, and marketing and sales. Delivery is dependent on deep integration with the individual BCBS companies and strong relationships with the Office of Personnel Management (OPM).
  • Market Solutions: Leads the development and ongoing performance of nationally consistent programs, products, services and capabilities that support local BCBS Plan growth and retention in key market segments including National Accounts, Medicare Advantage and Labor Unions. Solutions include national networks, national centers of excellence for high-cost specialty care, national physician/facility cost and quality standards and support for value-based care. Leads collective actions and scale plays to support and enhance BCBS company MA performance in STARS, HEDIS and CAHPS.
  • BlueCard: Responsible for the BlueCard Program-the infrastructure that enables local BCBS companies to serve national accounts and members who live in any ZIP code-which processes over 355 million claims a year. Leads BlueCard Modernization (BCM), a multiyear BCBS Systemwide initiative to modernize existing technologies, move claim transactions and clinical data to a cloud architecture and create new market-leading capabilities that enable BCBS companies to deliver a more consistent, differentiated experience to members and providers, regardless of location. Develops and implements data strategies to analyze at scale and leverage all data assets.
  • Information Technology: Leads BCBSA's IT organization to further align our future data and business capabilities, including technology infrastructure, architecture, security and development. Provides leadership to identify and develop shared technology solutions across the BCBS System to speed time to market and create efficiencies. Partners with external consultants and vendors to maintain core technology capabilities. Create efficiencies and opportunities using new technologies and Gen AI.
  • Inter-Plan Relationships and Governance: Influences and partners with all BCBS companies to ensure successful delivery of operational services and capabilities. Provide leadership on BCBSA Board agendas, meetings and strategic partnerships, inside and outside the BCBS System. Sets and oversees the execution of the three-year integrated operations and IT roadmap.
  • Analytics, Reporting & Measurement: Establishes metrics and reporting systems to assess the impact and results of all core operations with BCBSA and across the Plans. Works closely with the CEO and other members of the leadership team to embed analytics and develop process improvement for enhanced results and service.
  • Leadership: Provides leadership and guidance to BCBSA, BCBS companies, and internal and external stakeholders, furthering our mission and vision. Builds a culture to support BCBSA values and leadership competencies and delivers operational excellence and efficiency. Leads and mentors a high-performing team, fostering a culture of excellence, teamwork and innovation.

Experience and Skills:

  • Minimum 15 years of healthcare management experience; knowledge of health care delivery and insurance preferred.
  • Demonstrated ability to communicate, influence and summarize executive level discussions to drive results.
  • Experience leading teams through change and process optimization.
  • Strong organization, presentation, influence and communication skills.
  • A master's degree in health care administration, business administration or a related field is preferred.
  • Strong knowledge of health care industry trends, regulations and best practices.
  • Exceptional strategic thinking, problem-solving and decision-making abilities.
  • Proven ability to lead and inspire a diverse team.
  • Financial acumen and experience managing budgets.
  • Demonstrated success in stakeholder engagement and relationship building.
  • Strong commitment to the mission and values of Blue Cross Blue Shield Association.

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Make an impact on healthcare in America. A career with Blue Cross Blue Shield Association allows you to be part of the foundation that supports the 35 Blue Cross and Blue Shield companies nationwide, while protecting and strengthening the Blue Cross Blue Shield brand. Our work is helping provide greater access to cost-effective healthcare, improve the health of America and build stronger communities. With a commitment to diversity, equity and inclusion, we celebrate different cultures, languages, backgrounds and experiences while striving to advance health equity, and we want you to join Team BCBSA.

Accommodations:
Vision Accommodations, Hearing Accommodations, Neurodiversity, Learning, Mental Health, Mobility