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Consultant EGWP (Employer Group Waiver Plans) Operations

Employment type: 
Full time
Remote Position: 
Required degree level: 

Job Description Summary

Supports the vendor relationship, daily operations and the implementation of the EGWP Pharmacy program. Supports compliance activities, FEP policies and PBM contract, increasing the value of services to members and program stakeholders. Collects, maintains, and shares program operational and performance data. Supports timely resolution of inquiries, communication development, process documentation, reporting requirements and activities that support program compliance and audit needs.

Responsibilities include but are not limited to:

  • Responsible for the maintenance and publication of operational performance and production data reporting
  • Supports inquiry resolution and reporting needs. Identifies performance and compliance risks and communicates to leadership timely to minimize non-compliance.
  • Assist with managing, tracking and approvals for communication requests in compliance with CMS and FEP requirements/standards. Fosters collaborative relationships with internal and external business owners to determine best practices, operational efficiencies, or process improvements that enhance program performance and the member experience.
  • Participates in program implementations to capture tasks, milestones and action items. Provide historical reference by maintaining meeting minutes, and making updates to project schedules as needed.

Required Education, Certifications and Experience

  • Bachelors Degree in business, healthcare, information systems or related field.
  • Minimum of three years of experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics.
  • Project management skills for reporting multiple projects, involving multiple stakeholders, under tight deadlines.
  • Advanced organizational skills with the ability to develop approaches that meet required objectives.
  • Excellent communication (written and oral) and interpersonal skills with an ability to communicate to small and/or large audiences (both internal and external to BCBSA).

Preferred Education, Certifications and Experience

  • Experience in project management and/or account management
  • Experience setting priorities and meeting objectives for projects with multiple stakeholders
  • Technical proficiency with Microsoft Office, Teams and SharePoint.

People Management - No

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.

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