- Microsoft Office
- Microsoft Access
- Leadership Experience
Responsible for managing and coordinating Plan Benefit Cost Consulting staff and activities. Responsible for managing staff and strategic, multiple complex, cross-boundary projects, services and associated deliverables related to data analysis activities in support of FEP objectives. This includes organizing staff that consults with Plans to identify potential opportunities for benefit cost savings, through the development and implementation of benefit cost containment strategies and effective network strategies. In addition, this function provides leadership and overseas the Plan consulting activities and leadership in assisting and guiding Plan analytic staff with care coordination implementation and care management initiatives. This function is also the business leadership in managing and organizing staff in promoting appropriate use of FEP analytic tools for both Plan users as well as internal FEP users. This function will act as a senior internal consultant and manage junior level consultants in the identification, implementation, and/or development of analytical health care financing models to increase the value of services for Plans and internal customers. This function will manage internal staff that participates in and may lead larger, more complex projects, functioning as a strategic and technical resource as well as a subject matter expert.
Responsibilities include but are not limited to:
Manages and provides leadership for FEP Benefit Cost Plan Consulting activities. Manages Business Informatics staff, who serve as the Primary contacts between Plan analysts and Plan management in the support of all data analysis and reporting relative to benefit cost containment or other care management related activities. Continues to identify and assess opportunities for process/systems improvement.
Oversees and significantly contributes to the execution of complex projects and deliverables that cross many functional boundaries. Primary contact with Plan FEP management, Plan Management and multiple functional areas concerning the development, implementation and maintenance of benefit cost models and strategies for FEP.
Represents department and FEP on internal and external groups, as assigned. Build/maintain excellent relationships with internal and external business partners and/or customers. Serve as a liaison or contact between FEP analytics and key customers. Serves as an ongoing conduit of information from customers to appropriate BCBSA staff.
Oversees and/or conducts formal market assessments of best practices in the health industry addressing the management and use of healthcare information and determines the business value and practicability for FEP. Conducts a myriad of complex analyses, interprets findings, and develops recommendations and/or strategies to meet FEP and BCBSA core objectives. May lead or participate on team to take recommendation to implementation.
Required Basic Qualifications:
A minimum of ten years of experience within a business environment with a minimum of 7 years within a managed care or health services delivery setting, preferably with expertise in claims, provider contracting, benefit cost containment programs and/or healthcare informatics.
College degree with a health care concentration preferred (or equivalent health care experience).
Knowledge of SAS, SQL, Brio, or MCSource.
PC experience using database programs, spreadsheets, and word processing, including all components of MS Office (particularly MS Excel and MS Access).
Must have experience working with large data repositories and/or relational databases, as well as, experience with data mining.
Preferred Basic Qualifications:
Graduate degree in healthcare administration or other relevant concentration.
Experience in consulting on and implementing cost-effective care management programs is essential.
Ability to build consensus for business results in a decentralized decision-making structure, relying on excellent process management and conflict management skills including advanced time and resource management skills.
Competency in pursuing complex and innovative approaches to data analyses.
Ability to build consensus for business results in a decentralized decision-making structure, relying on excellent process management skills.
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