Business Lead Program Implementation

at Blue Cross Blue Shield Association in Chicago, Illinois, United States

Job Description

Provide business leadership and oversight for BCBSA Commercial Markets projects with the potential to significantly affect the development and operation of BCBSA's Programs. Responsibility for working with Commercial Markets management staff, Office of Policy and Representation (OPR), Legal Services and Plans to identify, analyze, summarize and report on industry requirements that could impact BCBSA's Programs. Responds to direction established by National Delivery management to lead in the assessment of the impact of industry initiatives to Commercial Markets' strategic imperatives.

Lead and facilitate appropriate Plan workgroups and forums, presenting proposals to key Plan management, working with Association staff in Commercial Markets, OPR, Legal Services and other areas, and leading discussions at Plan meetings. Provide the lead in obtaining approvals from appropriate governance workgroups on recommendations.

Lead all aspects of developing National Delivery solutions for implementing BCBSA projects. Collaborate with key internal and external stakeholders to identify implications to BCBS Plans' National Programs business operations. Conducts requirements gathering and analysis to support business needs, and develops strategy, policy and operational recommendations.

Influence the development of Commercial Markets' Program policies and health information management and technology initiatives by providing division staff with the appropriate perspective. Conduct research and develop recommendations to resolve inter-Plan disputes and to support other activities of Commercial Markets staff, such as National Delivery, Program Administration, Program Operations and Government Programs Delivery.

As assigned, provide oversight and guidance for national data standards to ensure implementation by BCBSA and Plans is successful and completed within the BCBSA budgets. Develop recommendations to meet evolving BCBSA and Plan needs specific to the pre/post effective date of standards implementation and other wide-scale initiatives.

Develop and maintain key contacts and effective working relationships with other divisions, Commercial Markets staff and Plan representatives as necessary to enhance knowledge of issues and to ensure the most effective collection and dissemination of information.

Education

Bachelors Degree
A bachelor's degree in a business discipline or equivalent experience (such as health information management or Health information technology (HIT).

Certifications

PHP certification is preferred.

Experience

Six years or more experience in related position

Skills

A bachelor's degree in a business discipline or equivalent experience (such as health information management or Health information technology (HIT).

Six years or more experience in related position

A background in health information management and technology or health plan/provider operations is desirable. Experience within the health payer and provider systems and an understanding of the health policy and standards development processes, and the commercial health insurance marketplace is desirable.

Effective organization, presentation and communications (oral and written) skills; presentation skills delivering technical information to a variety of technical and non-technical audiences with the ability to present information clearly and effectively within BCBSA and to industry stakeholders.

Analytical, planning and project management skills.

People Management

No

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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.