Overview

100% Remote - Full-Time Offsite for designated States

Develops, implements, and operates programs to support Blue Cross Blue Shield Plan competitiveness ingovernment programs, with a focus on senior markets. Provides leadership and subject matter expertisefor team that develops and operates inter-Plan products and services for Blue Plans. A successfulcandidate will develop and leverage relationships with Plan and external partners, refine existingprograms focused on gap closure and medical record retrieval, enhance operational and executivereporting and to anticipate opportunities and proactively implement solutions. Manage relevant inter-Plan workgroups and partner with other areas of Inter-Plan Programs to 1) assess Plan business needsand impacts of proposed solutions and 2) gain consensus for proposed Inter-Plan program solutions andenhancements. Impacts all Licensees and BCBSA organizations. Extensive interaction with Plan-basedworkgroups, governance committees and Plan staff in multi-disciplines, operations, technology, nationalaccount marketing, and provider relations.

Responsibilities

Responsibilities include but are not limited to:

• Government Markets Solutions - Lead development, implementation andoperations of business strategies, programs and initiatives to support nationaldelivery of Plan's products and services in government markets, includingMedicare and Medicaid. Leverage and enhance BCBSA, Plan and Systemwidereporting to improve operations. Anticipate changes in market and developoperational responses. Responsible for multi-year and annual Business Plans,including strategic initiatives roadmap, corresponding technology support, andcollaborating with appropriate business/technology partners to developcapabilities to meet market needs. Lead and guide teams in thedevelopment/enhancement and implementation of new and existing nationalproducts. Partner with internal stakeholders (e.g. Policy and Representation,Strategic Services, Clinical Affairs, FEP) to shape policy and legislative direction atboth the state and federal level to represent BCBS priorities. Implementcommunication strategies to effectively share the value of initiatives andsolutions throughout BCBSA and Blue Plans. Develop solutions to ensurenational delivery operations comply with federal and state regulations.Implement and operate a continuous improvement mindset to ensure effectivePlan support and operations.
• Management - Recruits, selects, develops and motivates team providing themwith appropriate training, assignments and opportunities to assume greaterresponsibility and to assure successful delivery of programs and initiatives.Promotes effective management across matrix organization using collaborativeprocesses and effective and timely decision making. Manages departmentbudget and resources to assure adherence to corporate and regulatory policiesand procedures.

Qualifications

Required Basic Qualifications:

• Bachelor's degree in business or healthcare or equivalent experience.
• 10+ years of progressive health insurance experience in combination of both business development and operations.
• Minimum eight years prior experience managing staff and budgets.
• Minimum of five years experience with the development and implementation of major government programs initiatives in support of large account business.

Preferred Basic Qualifications:

• Master's degree in health care administration.
• 5 years of progressive Blue Cross and BlueShield experience.
• 5 Years Five years of progressive experience in Medicare Advantage operations or product design

Equal Opportunity Employer

Blue Cross Blue Shield Association is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, disability, veteran status, genetic information or any other legally protected characteristics