Program Manager FEP Pilots

Employer
Blue Cross and Blue Shield Association
Location
Washington, DC
Posted
Sep 15, 2022
Closes
Sep 25, 2022
Ref
654251623
Industry
Insurance
Hours
Full Time
Overview: The Program Manager participates in the implementation of program models to increase the value of services for Plans and internal customers. Is responsible for the development of program models, and the collection, analysis, and maintenance of the program data. Participates in cross-boundary projects, services and associated deliverables related to data analysis activities in support of pilot programs. Functions as a technical expert, managing relationships with Plan contacts and vendors, providing tactical guidance regarding pilot programs. Resource to Plans for FEP related information regarding value-based programs and pilot programs. Responsibilities: Responsibilities include but are not limited to: Conducts formal market assessments of best practices in the health industry addressing payment for quality outcomes. Participates on teams to make recommendations to implementation.* Collects, analyzes, synthesizes and/or maintains complex data utilizing databases, survey instruments, information resources, or other research methodology. Supports Plans and business partners on data analysis and reporting in support of care management initiatives. Continues to identify and assess opportunities for process/systems improvement, and implement these strategies.* Collaborates with the Care Delivery Implementation and Benefits Operations team on initiatives. Resource for Plan FEP management, Plan management and multiple functional areas concerning program implementation, analysis, and statistical outcomes.* Implements new programs to increase value services. This includes planning, implementation, data analysis, and outcome management. Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with Plan and Federal Employee Program (FEP) goals.* Translates data analysis from programs that address Plan business needs and supports Federal Employee Program (FEP) strategic initiatives. Promotes creative clinical initiatives while ensuring correct pilot guidelines and processes. Leads or participates on team to take recommendation(s) to implementation.* Represents department and Federal Employee Program (FEP) on internal and external groups, as assigned. Builds/maintains excellent relationships with internal and external business partners and/or customers. Serves as a resource and ongoing conduit of information from customers to appropriate BCBSA staff. Qualifications: Required Basic Qualifications:3-5 years of experience within a business environment with a minimum of 2 year in a managed care or health services delivery setting, with experience in claims/coding, projectmanagement, finance and/or healthcare informaticsA Minimum of three years of experience in program implementation or project management.A minimum of 2 year in a managed care or health services delivery setting, with experience in claims/coding, project management, finance and/or healthcare informatics.A minimum of three years of experience in program implementation or project management.A minimum of 2 year in a managed care or health services delivery setting, with experience in claims/coding, project management, finance and/or healthcare informatics.Preferred Basic QualificationGraduate degree in healthcare administration or other relevant concentration or equivalent work experienceAdvance AHM certifications, certification by the American College of Healthcare Executives or Certified Health Consultant (CHC) certification is a plus. 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.