Director, Inter-Plan Programs

October 14, 2024

Industry: Private

Employment Type:- Full Time

Work Hours:- 8 Hours

Locations:- USA

Full Job Description:-

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

This role spearheads the Commercial Markets' initiatives to bolster the success of Blue Cross and Blue Shield Licensees by formulating and executing strategic priorities. These priorities augment the value of national programs, encompassing policy formulation, compliance stewardship, vendor oversight, budget establishment and maintenance, and the advancement of BlueCard operational programs. Anticipates market opportunities, proactively deploying solutions, and ensuring the daily operations of national solutions align with the Plans' and market's expectations. Leadership role necessitates close collaboration with cross-functional teams and stakeholders within BCBSA, Plans, and other entities to fortify existing programs and introduce new ones, and maintain the programs' market leadership. Leads the engagement and cooperation with essential internal and Plan stakeholders, formal workgroups, and Governance committees to facilitate the development and endorsement of solutions that deliver value to BCBS Plans, their accounts, consumers, and providers.

Primary Job Functions

Strategic Positioning - Responsible for creating and executing strategic plans and solutions that meet evolving market needs, including evaluating the effects on specific Plans and the System as a whole. Ensures that solutions align with market demands for accessible care, cost reduction, and enhanced efficiency. Guides teams to develop inventive and original solutions to meet market needs, as well as supporting improvements to current programs. Leads the creation and implementation of a multi-year business strategy that responds to present and future market challenges, BCBS Plan objectives, and the crafting of communications that highlight the value of the program.
Program Operations - Leads, directs, and establishes strategic priorities for the operations of all national programs, ensuring they demonstrate market leadership and fulfill Licensee requirements for national solutions. Oversees third-party relationships, including vendor selection, contract negotiation, and management, as well as daily operations, performance auditing, operational issue resolution, Plan education, and billing. Defines and implements system modifications and enhancements to the vendor systems that support Inter-Plan Programs Operations. Oversees the development and implementation of system changes and improvements for vendor systems that support the messaging of national program value and value analytics, including research on program value and effectiveness. Works closely with cross-functional teams and stakeholders within BCBSA, Plans, and external partners to ensure National Programs achieve success metrics, including operational SLAs, and foster growth and enhancement of quality and value. Guides the development, interpretation, and enforcement of compliance with policies for new and ongoing initiatives supporting all national programs. Collaborates with policy, legal, Brand, and other divisions to align License Agreements and Inter-Plan Policies, ensuring consistency across all governing documents.
Team Development - Leads and mentors staff to support the creation and enhancement of new solutions and improvements to existing programs, including evaluating Plan-specific and System-wide impacts. Ensures the department's success by selecting, overseeing, training, and assessing staff performance and the effectiveness of their contributions towards departmental goals. Provides impactful coaching and feedback to staff members and supports staff professional development.
Financial Oversight - Ensures the responsible oversight of revenues and expenses linked to national solutions, ensuring that programs are executed within budget and revenue goals are achieved.

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Education, Experience, And Certification

Bachelor’s degree in business or operations or equivalent experience.
Preferred: Masters degree in business, health care, or equivalent experience.

Required/Preferred Years of Experience Description

Required 10 Years
10 years’ business or operations experience within the healthcare industry.
10 years’ experience in project management and/or development and implementation of major initiatives in support of large national accounts.
7 years prior experience managing staff and budget.

Knowledge, Skills, and Abilities

Experience with strategic thinking and approach to problem solving.
Ability to develop key business partnerships both internal and external.
Effective organization, presentation, negotiation and communications skills (oral and written).
Ability to demonstrate good judgment and critical thinking relative to problem analysis/resolution at both the strategic and functional levels.
Ability to build effective relationships with cross-functional teams.
Demonstrated interpersonal skills for building and fostering key relationships.
Strong consensus-builder and negotiator.

Internals only

Please note that if you are an internal living in a non-commutable state, you are welcome to apply. However, you will be required to visit either the DC or Chicago office onsite work 20% of the time each month.

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