100% Remote - Full-Time Offsite for designated States
Develop strategies and solutions to address technical and business enhancements improving operational effectiveness for national healthcare delivery. For assigned projects, responsibilities include developing strategy, policy, operational recommendations, and ensuring smooth Plan implementations. Provides project leadership and drives the analysis and design of new business models targeted at improving the providers experience with supporting BlueCard, including coordination of solutions across the System. Responsible for defining business requirements and enhancements to current business processes, obtaining appropriate approvals from governance committees as needed.Requires the ability to work independently and effectively with multiple customers of varying levels including; Plan business and technical staff; BCBSA staff; Vendors; Governing bodies; and External workgroups. Supports the business needs of the Inter-Plan Programs division and Plan Customers to ensure solution meets defined business needs of all Plans.
Responsibilities include but are not limited to:
- Conducts detailed research and interviews to determine feasibility of emerging business opportunities, including impact to current business models for interPlan Program business functions. This role will be primarily focused on out-ofarea provider information and data sharing opportunities and performance oversight of new technical and process implementations. This will include but not be limited to analyzing the competitive environment, developing multi-year strategies for sharing data and information with out-of-area providers, and obtaining Plan approval through the BCBSA governance process for all solutions. Guides design of new business models based on Plan requirements in support of Inter-Plan operational processes
- Lead Plan workgroups to conduct business requirements and use case gathering to support business needs. Develops short and long term vision based on input from Sr. Management, Plan executives, user groups, workgroups or governance representatives. Provides leadership in all phases of BCBSA project management, adhering to related project methodology process standards. Provides support and direction to Analysts on the tracking and refinement of requirements, sharing expectations to ensure Plan interest are represented. Work with business and technical teams to assure effective development, testing and implementation of Inter-Plan capabilities.
- Create, Manage and present project roadmap, scope, status and other various project updates for Plans and internal leadership. Partners with Plans and BCBSA staff to ensure clear understanding of timeframes, deliverables, business expectations, and anticipated outcomes. Coaches and mentors business team members across Plans and BCBSA.
- Lead pilot and all Plan implementation efforts. Develops presentations and other educational communication materials in support of Plan training and education on new technical opportunities including SOPs, user guides, training presentations, all-Plan calls and demos, best practice sharing forums and others. Leads the development and presentation of materials to various audiences at various levels across Plans.
Required Basic Qualifications:
- A bachelor's degree in a business discipline or equivalent experience
- A minimum of 5 years' provider or health Plan measurement experience or healthcare equivalent.
- A Minimum of 7 years' experience in a combination of both product/business development and operations within the healthcare industry
- A Minimum of five years' experience in business process design analysis as well as business system design
Preferred Basic Qualifications:
- Good understanding of BCBS inter-Plan business is highly desired.
- Demonstrated understanding managing a full product development cycle from start to finish
- Business process modeling / system development lifecycle / project management expertise.
- Extensive knowledge of Health Care industry, specifically provider facing initiatives.
- Conceptual experience in systems development, designs and methodologies.
- Strong communication skills, written and presentation skills
- Strong organizational and multi-tasking skills
- Ability to motivate others to work together as part of a team is key
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