Executive Services ensures the timely and efficient resolution of Blue Cross Blue Shield of Michigan's highest-level grievances, complaints, appeals, inquiries, and referrals to maximize stakeholder satisfaction. We support the state and federal internal and external appeals process for PPO commercial members; fulfill Individual Rights requests on behalf of the organization; and respond to regulatory agencies. We handle executive employee inquiries and employee referrals on behalf of family and friends. Description: Accountable for and manages the development, implementation and ongoing maintenance of long-term project(s) typically spanning two years or more planning to implementation with relatively more complex scope and deliverables that may impact multiple business unit/function or business critical program. Project scope impacts one or more of the following: process, system, function, product and/or service. Project span across enterprise. Aligns with enterprise initiatives, multi-faceted and strategy. * Monitor progress, produce project status reports, timelines, budget reports, project metrics. * Plan projects, including the concept, design, planning, project scope, cost and benefits, testing, acceptance, implementation and post-implementation review of project deliverables. * Leads cross functional teams comprised of various internal customers and vendor resources. * Provide assistance and mentor staff on project management related issues. * Lead complex development initiatives. * Manage teams and ensure that project resources are utilized in an effective and efficient manner. * Ensure project goals are met or exceeded via the facilitation and resolution of barriers prohibiting the progress on projects. * Recommend and implement process changes to increase project execution performance. * Review system and tools to ensure quality and efficient implementation of development and enhancement efforts. * Monitor project risk and consult on mitigation plans. * May provide supervision to others. * Other duties as assigned. "Qualifications" * Bachelor's degree in related field required * Seven (7) or more years experience in related field * Five (5) years project management experience in health plan operations or related field * Project Management/ Project Management Certificate (PMP) preferred * Leadership and/or analytical experience with data, systems, and operations * Knowledge of program management preferred * Demonstrated proficiency and experience with project management applications, templates, development tools, and analysis tools required * Demonstrated knowledge and experience planning and leading high risk and complex projects * Knowledge of project management tools and methodologies * Knowledge of healthcare and/or managed care principles, computer systems, and claims databases * Extensive experience with analysis including root cause identification and problem solving * Knowledge of Michigan health care marketplace * Proficient in current industry standard PC applications and systems (e.g., Access, Excel and Word) * Demonstrated project management skills including the use of continuous quality improvement tools * Demonstrated competency planning and conducting reports and completing research reports * Excellent written and verbal communication skills All qualified applicants will receive consideration for employment without regard to, amongother grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
