Responsible for the execution of the portfolio of initiatives under the Provider Performance program. Manage the ongoing operations of these programs including, but not limited to, program performance, contract administration, program optimization efforts. Provide feedback to the strategy and ideation manager and lever owner to redirect future strategies.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
Lead and monitor multidisciplinary corporate programs/projects simultaneously by managing the establishment of project plans and objectives to ensure goal attainment within defined parameters.
Possess and maintain in-depth knowledge of BCBSM business, products, programs (including claims, reimbursement, benefits, provider and program data, networks, etc.), corporate organizational structure (including functional responsibilities), and complex research principles/methodologies.
Serve as trusted confidant and subject matter expert to senior leadership to support the training and execution of steerage programs, provide ongoing performance reporting, and feedback on the performance of programs to drive future strategic direction and ideation.
Work as collaborative leader across the organization.
Collaborate with business areas to implement proposed solutions and manage programs to evaluate effectiveness and results. Owns the wave process, including partnering with actuary, planning team, IT, and project management.
Ensure programs and initiatives encompass broad corporate scope and present significant variables.
Develop product materials to communicate to senior leadership, board of directors, and external providers on their individual performance relative to quality and affordability.
Anticipate, identify, and resolve challenges to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize, and control team activities.
Independently develop and plan, reports, papers and/or other materials.
Manage and own relationships with external stakeholders. This included management of assigned vendor(s) contracts, oversight of clinical decisions rendered by the vendor(s), development and management of vendor(s) operational business flows and other responsibilities as assigned.
EDUCATION AND EXPERIENCE
Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics, or another related field is required. Master's Degree in related field preferred.
Five (5) years of experience, typically in two (2) subject areas (e.g., planning, program management, project execution, provider / payer, health care policies, business decisions, analysis, stakeholder management, or business management).
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER SKILLS AND ABILITIES
Excellent analytical, planning, problem solving, verbal and written skills to communicate complex ideas.
Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).
Ability to work independently, within a team environment and communicate effectively with employees at all levels.
SUPERVISORY RESPONSIBILITIES
Directly supervises a varied number of employees in the designated department(s). Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
ADDITIONAL INFORMATION
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment.
Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity
Please see job description for required skills.
