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The hiring range for this role is: &nbsp;$224,000.00 - $271,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary: Responsible to BCBS Plan and other key stakeholders to provide clinical expertise and leadership for medical affairs strategy development and implementation. Serves as a thought and opinion leader to provide clinical leadership and support to internal and external strategic initiatives in support of BCBSA and BCBS Plans. Works collaboratively with other medical directors to provide consultative leaders to the development of evidence-based reference medical policy information. Designs and implements innovative solutions that enable BCBS Plans to be proactive and that also enable industry leadership.Responsibilities include but are not limited to:<ul><li>Medical Affairs Leadership-Responsible to BCBS Plan and other key stakeholders to provide clinical expertise and leadership for medical affairs strategy development and implementation. Serves as a thought and opinion leader to provide clinical leadership and support to internal and external strategic initiatives in support of BCBSA and BCBS Plans. Provides clinical guidance and support to initiatives that address public health issues. Implements deliverables in support of BCBSA Board strategies and OCA key initiatives</li><li>Reference Medical Consultation-Collaborates with other medical directors to provide consultative leader and direction to Medical Policy Service in the development of evidence-based reference medical policy information.</li><li>Communication Management-Publication: Manage and undertake process improvement for the internal communication on timelines, evidentiary review, and deliverables. BCBSA Board Strategies: deliver the identified content in support of the BCBSA Board Strategies, including precision medicine and medical policy management</li><li>Ensure strong Thought Leader (TL) relationships; develop and nurture relationships with Key Opinion Leaders (KOLs) and consultants in the clinical community in order to strengthen BCBSA’s leadership position; serve as a professional representative of OCA in the healthcare community. Share responsibility with Clinical Operations for decisions regarding the recruitment and retention of pharmaceutical, medical device, as well as new business opportunities and strategies for product/platform development.</li></ul>Required Education, Certifications and Experience:Education<ul><li>M.D. or D.O.</li></ul> Certifications<ul><li>Medical license</li><li>Board certification</li></ul> Experience<ul><li>A minimum of 5 years health plan experience, as Medical Director or Medical Consultant with responsibility</li><li>Experience in representing Medical Affairs and Clinical Operations to consumers, businesses, providers and media</li></ul> Skills<ul><li>Demonstrated knowledge and experience of interaction of clinical operations with other Plan functions including but not limited to medical management, medical policy, legal, marketing, media, government relations, provider contracting etc.</li><li>Knowledge of medical policy implementation, claims operations and provider and account relations</li><li>Works effectively in cross functional teams</li><li>Works effectively with Plan Medical Directors</li><li>M.P.H. or other advanced degree is desired</li><li>Written communication and presentation skills</li></ul> People Management<ul><li>No</li></ul>#LI_HYBRID

Blue Cross Blue Shield Association

Medical Director, Medical Affairs

The hiring range for this role is: &nbsp;$140,000.00 - $150,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.The Client Invoicing Business Partner is responsible for leading and ensuring support for our participants for medical rebate concerns. In addition, this role will partner with financial operations on delivery of Synergie’s key initiatives, translating strategic plans into meaningful implementation strategies and project plans while providing insight from a participant perspective. The role will be responsible for driving appropriate oversight for our participants, structure, and governance to achieve ideal business outcomes. In addition, this role will work collaboratively with senior leaders, and key stakeholders to oversee work efforts, identify interdependencies, and ensure cross-initiative solutions are in alignment.Primary Job Functions<ul><li>Ensure participants are supported for invoicing issues. This includes working with internal team members and invoicers to obtain answers.</li><li>Learning the in-depth daily work requirements and processes of medical rebates</li><li>Engage with financial operations team on all aspect of medical rebates including daily stand-up issue resolution discussions</li><li>Meet consistently with participants and their plans to address questions or concerns on invoicing in a timely manner</li><li>Maintain alignment and identify strategic initiative interdependencies between all workstreams related to assigned initiative to support participants</li><li>Create and deliver executive level presentations articulating business objectives, progress, challenges, and successes in stated objectives on participants needs, concerns, and feedback</li><li>Drive transition, rollout, and oversight of change management activities for participant impacts</li><li>Identify and manage interdependencies between strategic initiatives and operational areas to achieve intended value delivery objectives; identify, aggregate, and manage macro-level risks across same scope for participant communication</li><li>Work with VP of Client Relations on any participant communications on invoicing</li><li>Facilitate planning with dependent projects and products including relevant stakeholders and owners to align on program roadmap and goals, budget, and schedule</li><li>Work with implementation team on participant insight, impact, or communication on any invoicing updates</li><li>Other duties as assigned</li></ul>Education, Skills, and ExperienceEducationRequired:<ul><li>Bachelor’s degree in Business or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required</li><li>10 years of work experience in client relations, rebates, project management, business analysis, or other related experience leading company- wide cross-functional work efforts</li><li>Must be eligible to work in the United States without need for work visa or residency sponsorship</li></ul>Knowledge, Skills, and Abilities<ul><li>Extensive client experience and resolution management experience</li><li>Strong analytical, organizational, and time management skills</li><li>Proven ability to counsel and influence at the executive, C-level</li><li>Proven ability to effectively build, lead and motivate a high performing program team without direct reporting relationships, establishing trusted relationships, promoting candor, and driving results to ultimately achieve all program objectives</li><li>Strong communication skills with ability to communicate information in open and sincere manner that promotes credibility</li><li>Excellent collaborator with track record of working with multitude of different groups, personalities, and levels of people to facilitate resolution of different views</li><li>Ability to work as team player, comfortable with fast paced, changing environment and ambiguity</li></ul>Preferred Qualifications<ul><li>Previous Client Engagement Experience</li><li>Previous Program Management experience</li><li>PBM/health care experience</li></ul>Revenue Responsibility: NoBudget Responsibility: NoPeople Management: NoRole Designation: Remote#LI_REMOTE

Dir Client Invoicing Business Partner - Synergie Medication Collective

The hiring range for this role is: &nbsp;92,086.00 - 129,145.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.The Product Owner leads the efforts of defining the product backlogs by working closely with the team of business analysts, architects, technical SMEs and business owners. This role’s accountabilities include writing features, defining User stories, and working with Scrum Masters and business owners to align on business objectives and product implementation. Requires a solid knowledge foundation of business, operations and/or technical components of a health insurance organization.Follows the Agile methodology and process to support delivery. Participates in daily scrum stand-ups, retrospectives, product demonstrations and other scrum ceremonies. Writes Features and works with the team to define User Stories and manages them in the product backlog. Works with business owner to determine priority and assign the priority for Features and User Stories in the backlogs. Define the Minimal Viable Product (MVP) for the product features. Assists with communicating the technical challenges/hurdles to business owner and help resolve the issues related to business in working with the Production Support team. Provides inputs to business owner in defining the strategic business roadmap to achieve the program vision. Guides business analysts on how to break down the MVP into the User Stories and has oversight on effective User Stories. Provides inputs to the Scrum Masters on improvement opportunities with refinement sessions. Engages with business stakeholders to educate, learn, and provide input to support/improve Agile delivery. Supporting Team building and Team development by utilizing the abilities and skills of individuals and fostering a feedback culture. Develop materials for presentations and present product changes to stakeholders. Provide input in training materials through partnership with Member Education team.Education Bachelor’s Degree in related discipline or equivalent work experience within a similar environment Certifications Preferred but not required Product owner certification (Scrum or Scaled Agile Framework) Experience Minimum of 5 years’ experience in operations, IT, or business, with emphasis on product design/ development/ implementation 2 years related experience in the health insurance industry Experience in multi-tasking environment with ability to effectively assist and/or manage multiple projects concurrently; with the ability to function in a team-oriented, cross functional/matrixed environment Previous success as a Product Owner experience in a dynamic high-technology environment. Hands-on experience with Agile practices, Scrum process, Kanban etc. Skills Excellent communication, interpersonal and presentation skills. Analytical skills coupled with health insurance acumen. Organization, prioritization and time management skills. Business savvy to understand the product needs of the future and influence all stakeholders to prioritize them. Knowledge of Systems Development Lifecycle and the Project Management Lifecycle. Problem solving skills. Project Planning skills. People Management NoInternals onlyPlease 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 the DC office onsite 20% of the time each month.#LI-Hybrid

Product Owner

The hiring range for this role is: &nbsp;$290,000.00 - $330,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary: The Vice President, Finance provides strategic leadership for BCBSA’s financial strategy, management, accounting, and technology services. Responsibilities include reporting to the Board and Finance and Audit Committee, overseeing Licensee Financial and Enrollment performance monitoring, and delivering high-quality services to Plan CFOs and senior financial constituencies. The position also focuses on building an adaptable, consultative, customer-focused team and maintaining expertise in industry best practices and technologies while fostering effective relationships with internal and external partners.Responsibilities include but are not limited to:<ul><li>Provide effective leadership to the Finance team, oversee the Management Team in managing the day-to-day operations. Coach, motivate, and implement appropriate training and career development opportunities for team members. This includes the communication and ongoing facilitation of performance feedback and appraisal processes. Serves as an active member of the BCBSA Senior Leadership Team</li><li>Provide leadership and strategic direction for the financial accounting function including payables, receivables, payroll, and tax preparation. Ensure there is an effective system of internal controls, including the development of financial policies and procedures. Work with internal and independent auditors to ensure reliable financial reporting, comply with applicable laws &amp; regulations, and safeguard Association assets.</li><li>Drive successful financial performance leveraging effective leadership of Financial Planning and Analysis, Decision Support, Forecasting, Budgeting, Resource Management and Management Financial Reporting. Builds and maintains consultative relationships with stakeholders across BCBSA, providing data and insights to support business decisions.</li><li>Oversee establishment and maintenance of system-wide policies on financial and enrollment reporting practices. Ensure credible Licensee financial and enrollment data is reported to BCBSA to support effective programs for licensure, compliance, and performance monitoring.</li><li>Manage the Insurance program for the Association and related Affiliate entities working with internal and external legal staff to evaluate risks, recommend insurance coverage where needed, and acquire coverage.</li><li>Develop and deliver high quality, timely, value-added services to Plan CFOs and other Plan executives.</li></ul>Required Education, Certifications and Experience:Education<ul><li>A Bachelor’s degree in Accounting or Business with an Accounting concentration which demonstrates knowledge of GAAP (Generally Accepted Accounting Principles) and Federal &amp; State regulations with CPA or MBA required</li><li>Master's Degree (Preferred)</li></ul> Certifications<ul><li>CPA (Preferred)</li></ul> Experience<ul><li>Ten (10) years of experience in a broad business background as well as a degree in Accounting or Business demonstrating extensive knowledge of GAAP, Government and non-government legal, regulatory and practice conventions required including FAR and CAS.</li><li>Eight (8) years of experience developing and managing staff</li></ul> Skills<ul><li>Knowledge of FEP, IRS and State regulations is required.</li><li>Demonstrated ability to manage, develop, motivate and provide leadership to management and staff.</li><li>Strong interpersonal skills required to lead in an employee empowered environment.</li><li>Demonstrated ability to manage multiple tasks in a fast-paced environment and the ability to effectively communicate results to senior management, other officers, Plan executives and board members of the Association.</li><li>Proficiency in various database and computer-based applications such as Workday, Power BI, Tableau, PeopleSoft, Excel, Word, and PowerPoint.</li><li>The ability to verify completed product, a detailed orientation is critical.</li><li>Effective written and verbal communication skills</li><li>Excellent organizational skills and demonstrated ability to manage multiple critical and time-sensitive activities in a fast-paced environment while maintaining poise and composure</li><li>Strong project management skills</li><li>Excellent customer service and a strong customer orientation and the ability to maintain and improve customer relations</li><li>Proven leadership abilities to guide staff in the development of new initiatives and system efficiencies; strong leadership skills to plan, manage, and direct operational functions with ability to implement change</li><li>Strong presentation skills and the ability to communicate concepts, issues, and proposals in a concise and compelling manner to small and large audiences at all levels in the organization as well as external parties; ability to conduct value-added and informative presentations to all levels of staff.</li></ul>Relationship management skills:<ul><li>Ability in the development and maintenance of business relationships</li><li>Ability in dispensing exceptional customer service and a strong customer orientation and the ability to maintain and improve customer relations</li><li>Strong quantitative, analytical, problem resolution skills, with financial concepts are preferred.</li></ul>People Management<ul><li>Yes</li></ul>#LI_HYBRID

VP, Finance

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.The Product Director will have business ownership overseeing the full lifecycle development for one or more of the inter plan product capabilities. They will lead a cross functional direct/matrix team through strategy, vision and execution applying product management paradigms. They will gain BCBSA and Plan consensus and governance approval of proposed strategies to address market needs. Accountable for building cross-functional relationships and strategic partnerships to fully assess impact of solutions, gain adoption of solutions and to develop communication strategies. This includes building bridges internally and within Plans between business and technology staff through effective strategic planning and prioritization. Accountable for building and maintaining strong working relationships with vendor partners including Blue Health Intelligence (BHI) and Consortium Health Plans (CHP). Represent BCBSA interests in national and government/regulatory forums. Frequent Plan interaction to present business case for initiatives and gain consensus.Leads and directs the transformation of one or more Enterprise Data Solutions assets, transaction processing capabilities and information assets, enabling the Blues to distinguish themselves in the marketplace. As Business owner, be responsible for system solutions and development of inter-plan capabilities including but not limited to member/claims capabilities, informatics applications, consumer engagement applications, and data services. Leads and directs cross-functional efforts and develops business justification for solutions that meets goals and objectives. Proactively implements and explores new solutions in support of emerging business needs and enhanced efficiencies. Responsible for directing the assessment of alternate solutions including the analysis of Plan specific and System-wide impacts associated with solutions. Accountable for improving the functionality, efficiency, and quality of support to Plans for business application solutions and for interactions with EIT division. Leads long-term planning and strategy development for one or more products including identifying business value, resource requirements and budget/timelines to ensure successful implementation internally and with Blue Cross Blue Shield Plans. Leads and directs the development of business requirements in response to strategic priorities. Accountable for building bridges between business staff and technology staff through leadership of cross-functional relationships, strategic planning and prioritization of enhancements and new requirements. Responsible for ensuring all inter-dependencies are appropriately identified and accounted for. Responsible for the financial management of business application projects, initiatives and ongoing support and maintenance budgets, including the development and execution of long-term business plans for one or more National Programs applications. Accountable for gaining BCBSA, Plan consensus and governance approval of proposed inter-Plan business applications and technology solutionsEducation Bachelor’s and Masters Degree in business, information technology, data analytics, healthcare or the equivalent work experience. Experience 7 years’ of experience with the development and implementation of major initiatives including cloud based applications. 5 years’ experience managing staff and budget. 10 years’ experience in progressive health insurance, in combination of both product/business development and operations. 10 years’ experience in software development methodologies and product management. Experience leading large data warehouse and analytical applications. Experience leading organization-wide initiatives and building consensus for business results in a decentralized decision-making structure. Demonstrated ability to lead in a matrixed environment. Experience with Agile development methodologies. Project management experience; demonstrated ability to set priorities, lead a team to meet objectives for complex projects involving multiple stakeholders, and execute according to plans and budget. Experience in the development of product roadmaps and strategies preferred. Analytic experience relating health care data preferred. Skills Relationship management skills.: Ability to work across all levels of the organization, including working with BCBSA staff, Plan executive and management audiences and vendors., Strong customer-service mindset.; Ability to develop key business partnerships both internal and external, build peer relationships. Strong consensus-building skills in a decentralized decision-making structure. Data analytical skills; ability to analyze data and processes, options, and alternatives to provide recommendations; analyze alternatives to derive final recommendations. Communication skills (oral and written): Demonstrated ability to effectively communicate recommendations, solutions, and project status to customers, senior management. Ability to communicate across multiple business and technology teams. Problem resolution skills: Ability to gain various viewpoints and arrive at critical decisions. The ability to problem solve independently and as part of a team. Demonstrated strategic thinking and approach to problem solving. Effective organization, presentation, and negotiation skills Ability to demonstrate good judgment and critical thinking skills relative to problem analysis/resolution at both the strategic and functional levels. Demonstrated ability to influence outcomes preferred. Extensive knowledge of Health Care industry and Health insurance systems and processes preferred. People Management YesInternals onlyPlease 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.#LI-Hybrid

Product Director

The hiring range for this role is: &nbsp;107,666.00 - 150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary: This role oversees the design, development, administration, and optimization of Blue Cross Blue Shield Association’s web properties. This role involves close collaboration with business stakeholders, designers, IT partners, developers, content creators, and marketing professionals to ensure top-notch performance, user experience, search engine optimization, and stability.Responsibilities include but are not limited to:Primary Job FunctionsWebsite Management: Oversee content management solutions platforms day-to-day operations including development, maintenance, enhancements, integrations and performance. Manage regular website release schedule and follow agile sprint cycle. Ensure adherence to accessibility and usability guidelines for all websites. Engage and collaborate with technology counterparts to ensure successful testing of all system updates, upgrades, launches, enhancements, system integrations. Help manage third-party partners and vendor, tracking and communicating progress, and monitoring performance. Also includes publishing of new pages and approved content and updating existing content as requested by business stakeholders—employing SEO, UX/UI, accessibility and web design best practices.Cross-Functional Collaboration: Work closely with key stakeholders such as business stakeholders, designers, IT partners, developers, content creators and marketing professionals to ensure effective use of the CMS platforms and identify ways to improve the visitor experience. As needed, act as a liaison between IT and business owners, representing business needs in regard to enhancements and defect resolution.Leadership: Guide the workloads and responsibilities of direct report(s) as they support the day-to-day operations of the company’s internal and external web platforms.Performance Management: Utilize data and insights to continuously optimize web experiences, track performance metrics, and identify opportunities for improvement.Required Education, Certifications and Experience:Education<ul><li>Required: Bachelors Degree</li></ul>Experience<ul><li>Required: 5+ years of web development, design or management, digital marketing, or related roles. Worked closely with and understand information architecture, user experience, analytics, testing and development. </li><li>Required: Hands-on experience working in development, staging and production of a wide array of CMS environments.</li></ul> Certifications<ul><li>Required: Google Analytics certification and experience working within Google tools, such as Google Tag Manager, Search Console, Google 360, Looker Studio, etc. </li></ul> Knowledge, Skills, and Abilities<ul><li>Expert knowledge of a wide array of CMS platforms, including Drupal, SharePoint, dotCMS.</li><li>Functional knowledge of Adobe Creative Suite software (Photoshop, Dreamweaver, etc.)</li><li>Familiarity with email marketing software and campaign creation</li><li>Ability to work against tight deadlines in a fast-paced environment, and work on multiple projects simultaneously.</li><li>Must be a self-starter, highly motivated, strategic and adaptable thinker that develops innovative solutions and delivers against tight deadlines while keeping a keen eye on detail and accuracy.</li><li>Commitment to stay at the front of the industry regarding digital trends, continuously bringing outside perspectives and best practices.</li><li>Strong analytical skills, and proven track record in making data-driven decisions to continually optimize performance and determine future work and investments.</li><li>Knowledge of web programming languages, including HTML, CSS, SQL, JavaScript, and PHP, is required.</li><li>Ability to work against tight deadlines in a fast-paced environment, and work on multiple projects simultaneously.</li></ul><ul><li>Revenue Management: No</li><li>Budget Management: Yes</li><li>People Management: Yes</li></ul>#LI_HYBRID

Website Manager

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary: Responsible and accountable for overall delivery of Enterprise Information Technology (EIT) technical solutions initiatives. Serves as the single point of contact within EIT for delivery of complex technology solutions. Works cross-departmentally and cross-organizationally to ensure the successful delivery of EIT technology solutions initiatives.Responsibilities include but are not limited to:Technical Solution Delivery: Accountable for overall technical solution delivery for assigned initiatives. Serves as the central point of contact within the organization for successful delivery of assigned overall technical solutions. Responsible for EIT cross functional coordination (Systems Analysis, Software Engineering, Performance Engineering, Product Verification, Service Delivery, Customer) to ensure overall delivery objectives are met. Serves as the primary point of contact for Business, Senior EIT Management, and EPMO to ensure successful overall EIT technical solution delivery. Solution Delivery Controls: Establishes and maintains effective overall controls for technical solution delivery initiatives. Works with business and EPMO to define overall solution scope. Works with EIT functional teams to estimate requested scope and identify team resource work capacity. Balances scope estimates and capacity to ensure overall technical solution delivery can be successfully accomplished. Works with business and EPMO areas to address any gaps in scope verses capacity. Works with all teams to identify and document technical delivery milestone dates. Reviews estimates and verifies cross-team consistency. Accurately documents and manages assumptions for technical solutions delivery. Concisely and clearly provides status updates on technical solution delivery initiatives. Ensures adherence to all technical solutions methodology processes and practices, including reviews, walkthroughs and sign-offs. Leadership: Provides overall cross-team leadership to drive technical solution delivery to a successful conclusion. Works proactively to identify and address issues. Works with all EIT teams and BCBSA teams, to identify and implement solutions to issues. Maintains momentum of all teams to achieve overall technical solution delivery. Relationship Management: Works across all teams in a collaborative and effective manner. Navigates solutions to issues with a win-win approach, where all stakeholder needs and inputs are considered and balanced. Maintains positive and constructive working relationship with all participants in the technical solution delivery initiatives. Application of Technical Skills: Works on an as-needed basis as a hands-on technologist, applying technical skills in the development and delivery of technical solutions. Follows established technical solutions methodology processes and practices throughout the technical solutions delivery initiatives.Required Education, Certifications and Experience:Education<ul><li>High School Diploma or GED</li><li>Bachelor’s Degree in Computer Science, Information Systems, Business Administration or equivalent work experience.</li><li>Master's Degree (preferred)</li></ul> Certifications<ul><li>AWS Certified Cloud Practitioner (preferred)</li><li>Certified AWS solution architect and security (preferred)</li></ul> Experience<ul><li>Minimum 10 years of IT work experience including application system design and implementation.</li><li>Experience developing and integrating technical solution components.</li><li>Experience with Value-based, Care Management, or Disease Management analytics platforms</li><li>Experience leading technical delivery programs and projects, including, managing the full SDLC, issue/risk resolution, status reporting, dependency management, technical team communication, and deployments</li><li>Experience managing and controlling technical delivery release scope, including, soliciting business priorities from Business customer directly and leadership team, organizing scope into releases, building roadmaps, key tasks lists, manage scope changes, and communicating scope augmentations to program leadership, project management, and technical team</li><li>Experience managing technical estimates, including, estimation planning, managing the technical team to deliver estimates, and writing vendor Statement of Work verbiage</li><li>Experience with vendor relationship management, including, assuring vendors are meeting contract expectations, conducting deliverable reviews, and providing formal documented vendor feedback</li><li>Experience with program and project procurements, budgeting, and forecasting, including, managing contract project dollar allocations and progress toward contract dollar limits for all projects on contract, vetting contract modifications, partnering with enterprise procurement team, and approving invoices</li><li>Experience with implementing and identifying opportunities for project/program technical delivery improvements, including, process improvements, quality management improvements, knowledge sharing/knowledge management improvements, collaboration tool improvements, and program reporting tool improvements</li><li>Experience with multiple development methodologies, including RUP and Agile.</li><li>Experience in Office 365 suite of tools, including but not limited to SharePoint Online, Groups, Teams, Yammer, OneDrive, Power BI, Power Automate.</li><li>Blue Cross Blue Shield Plan experience (preferred)</li></ul> Skills<ul><li>Strong background and deep understanding of healthcare industry Value-based, Care Management, or Disease Management data, Business processes, and their member lifecycle</li><li>Ability to discuss key Value-based, Care Management, or Disease Management topics and analytics with Business partners at their level of competence of the topic</li><li>Strong facilitation skills with driving Business experts to decisions and technical teams to solutions</li><li>The ability to develop and maintain business relationships</li><li>Excellent presentation development skills and verbal presentation skills</li><li>Strong technology project management skills</li><li>Strong team-oriented interpersonal and communication skills to cultivate positive working relationships</li></ul> People Management<ul><li>No</li></ul>#LI_HYBRID

Technical Solutions Director

The hiring range for this role is: &nbsp;$180,000.00 - $215,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary The Managing Director, Security Operations, Incident Response &amp; Threat Hunting will manage the team responsible for various security services in domains of Security Operations, Incident Response, and Threat Hunting. This role will lead a team of security engineers, analysts, and administrators responsible for maintaining security infrastructure, responding to security alerts, investigating/triaging security incidents, performing forensics detailed forensics analysis, building detection and monitoring rules, and building custom incident response tooling.Responsibilities include but are not limited to: ​<ul><li>Manage all SoC operations, technology administration, threat hunting programs, Incident response processes.</li><li>Establish processes to measure and report on team performance and business value.</li><li>Work with various business stakeholders to demonstrate the business value and operational outputs of the team at an executive level.</li><li>Ensure that forensic evidence is preserved and can be used for legal proceedings if necessary.</li><li>Research and monitor emerging security technologies, understand current industry and technology trends and opportunities, and assess their impact to the business.</li><li>Conduct research to identify new attack vectors facing BCBSA computing environment.</li><li>Work with and influence business contacts in regards to technology controls, risk mitigation techniques related to application layer security.</li><li>Develop and maintain applicable incident management program metrics for continual measurement and improvement.</li><li>Manage and motivate teams with diverse skills and backgrounds.</li><li>Assess and prioritize security risks and formulate effective risk management mitigation plans.</li><li>Collaborate with cross-functional teams to integrate security measures into business processes and applications.</li><li>Regularly review and update security documentation to reflect changes in the threat landscape and business requirements.</li><li>Participate in security audits, assessments, and certification processes.</li><li>Work closely with legal and compliance teams to address any security-related legal and regulatory requirements.</li><li>Lead incident response efforts, including investigation, containment, and resolution.</li><li>Lead post-incident analysis and implement corrective actions to prevent future occurrences.</li><li>Participate in the selection, implementation, and maintenance of security technologies.</li><li>Communicate effectively with stakeholders, addressing security concerns and providing guidance on best practices.</li><li>Assist in security-related documentation (RFPs, PPTs, etc.)</li></ul>Required Education, Certifications and Experience<ul><li>Bachelors Degree Computer Science, Information Technology, or related field required.</li><li>Minimum of 10 years information security experience with a heavy technical focus and with 7 years of progressively increasing responsibility.</li><li>Minimum of 5 years in a leadership position as a hiring manager or team lead capacity with experience developing and leading staff.</li><li>Experience/knowledgeable in conducting audits of information systems and their application to ensure accuracy of information and promote operational efficiency</li><li>Experience acting in a security incident response role with responsibility of analyzing alerts/threats, responding accordingly, developing incident response plans and procedures</li><li>Experience documenting incident cases and managing lessons learned meetings</li><li>Experience in working with Managed Security Service Providers (MSSPs) and ensuring alignment to agreed upon SLAs.</li><li>Experience in implementing and managing core TVM systems and processes such as: Security Event Management, Vulnerability Management, Web application firewall, data base monitoring, forensics toolsets, firewalls, proxies, packet captures, etc.</li><li>Experience in managing Information Security operational and capital budgets.</li><li>Experience with implementation of technical security architectures within a large enterprise environment is preferred.</li><li>Competency in making operational decisions, monitoring progress and reporting results.</li><li>Ability to communicate at all levels, with experience in leading operational review meetings with business partners and executives that may range from technical resources to VP/SVP.</li><li>Technical domain knowledge along with understandings for the costs for delivering the required services</li><li>Competency to Interpret and summarize technical information for presentation to non-technical business contacts</li><li>Knowledgeable in security technologies, procedures, and best practices to include functions such as Web Application Firewalls, Intrusion Detection Systems, Endpoint Detection and Forensics, SIEM, and Vulnerability Scanning</li></ul>Preferred Education, Certifications and Experience<ul><li>CISSP, CRISC, CISA or other relevant certifications preferred</li><li>Knowledge of the BCBS system and practices.</li></ul>People Management Yes #LI-Hybrid

Managing Director,  Secuity Operations

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Serves as clinical director of the Federal Employees Program pharmacy programs. Provides leadership and direction for the Federal Employees Program prescription drug benefit programs and Blue Cross Blue Shield Association initiatives to promote the cost-effective use of pharmaceuticals. Provides leadership in the development, management and evaluation of the Service Benefit Plan Formulary. Keeps abreast of and interprets trends within the pharmaceutical marketplace and healthcare industry which could affect pricing, delivery system, and benefit coverage and provider utilization and formulates strategies to respond to trends. Project responsibilities include project coordination, ability to set priorities, consensus building and providing reports to both peers and Executive level.Primary Job Functions<ul><li>Develops, manages, and evaluates drug formulary, drug utilization review programs, fraud and abuse programs, safety and quality monitoring programs. In addition, provides oversight over Pharmacy Benefit Manager clinical programs.</li><li>Interacts significantly with the Pharmacy and Medical Policy Committee as policies are being drafted for final review of the full Pharmacy and Medical Policy Committee. Has oversight of the contract and activities of support vendor for Pharmacy and Medical Policy Committee: creation of monographs, drug and class reviews. Presents recommendations for final vote of from Pharmacy Policy to Pharmacy and Medical Policy Committee members.</li><li>Formulates and coordinates integration of pharmacy clinical programs with overall Federal Employees Program administrative policy.</li><li>Provides leadership and support to pharmacy work groups, best practices, and forums.</li><li>Initiates new programs for managing utilization and increasing cost savings.</li></ul>Education Required: Doctor of Pharmacy degreeExperience:Required: A minimum of 5 years related work experience including 3 years in a leadership role.Certifications Required: Currently licensed as a pharmacist in the state of Maryland Knowledge, Skills, and Abilities<ul><li>Knowledgeable about how health care and patient care is delivered and how health care professionals interact in the health care environment, e.g., progressive experience in managing drug utilization review and formulary programs as well as Pharmacy and Therapeutics Committee experience.</li><li>Technical proficiency with information technologies (Microsoft software applications) is required.</li><li>Excellent interpersonal skills and presentation skills, including the ability to work with all levels of the Association, Plans, government agencies and vendors.</li><li>Leadership, organizational, analytical, and project management skills are also imperative, as well as the ability to solve problems, make sound business decisions, and communicate effectively, both in writing and orally.</li></ul>Revenue/Budget Management: NoPeople Management: NoTravel Requirements: 11-25%#LI-Hybrid

Director of Pharmacy Policy

The hiring range for this role is: &nbsp;78,638.00 - 110,285.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.The "Consultant Employer Group Waiver Plan (EGWP) Operations position supports the vendor relationship, daily operations, and delivery of member benefits for Medicare Part D Employer Group Waiver Plan (EGWP). This position collects, maintains, and resolves issues, shares program operational and performance data, supports timely resolution of inquiries, communication development, process documentation, reporting, implementation, compliance, and audit activities in support of and in compliance with the Federal Employee Program (FEP) Program, CS 1039, Office of Personnel Management (OPM), and Centers for Medicaid Services (CMS) EGWP Part D policies and regulations.Primary Job Functions<ul><li>Oversees accurate and timely resolution of member inquiries including but not limited to CMS, OPM, internal and external sources.</li><li>Identifies performance and compliance risks and communicate to leadership timely to minimize non-compliance. Reviews and tracks weekly, monthly, and quarterly reporting to identify any issues and implement corrective action strategies as needed.</li><li>Assists with managing, tracking and approvals for communication requests, system updates, benefit changes in compliance with CMS and FEP requirements/standards.</li><li>Support and interact with internal and external stakeholders to provide timely resolution to inquiries and issues.</li><li>Fosters collaborative relationships with internal and external stakeholders and vendor account teams.</li></ul>Increase Program value:<ul><li>Implements new programs to increase the value of our services. This includes planning, implementation, data analysis, communications, and outcome management.</li><li>Review trends and industry information to determine best practices, operational efficiencies, or process improvements to enhance program performance and the member experience.</li></ul>Compliance:<ul><li>Support development of operational standard operating procedures (SOP), policy, brochures, training materials and curriculum.</li><li>Assist and support contract proposals, negotiations, counter proposals, SLA development, contract modifications and amendments.</li><li>Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with FEP goals.</li><li>Support audit and compliance activities.</li></ul> EducationRequired: Bachelor’s degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience. Experience Required: Minimum of three years of experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics Preferred: • Experience in project management and/or account management• Experience setting priorities and meeting objectives for projects with multiple stakeholders• Technical proficiency with Microsoft Office, Teams and SharePoint Knowledge, Skills, and Abilities<ul><li>Project management skills for reporting multiple projects, involving multiple stakeholders, under tight deadlines</li><li>Advanced organizational skills with the ability to develop approaches that meet required objectives</li><li>Excellent communication (written and oral) and interpersonal skills with an ability to communicate to small and/or large audiences (both internal and external to BCBSA)</li><li>Technical proficiency with information technologies (e.g. Microsoft software applications)</li><li>Interpersonal skills with the ability to work with all levels of the Association, Plans, government and vendors</li><li>Ability to manage stakeholders and reconcile and integrate competing interests</li></ul>Revenue/Budget Responsibility: No People Management: NoTravel Requirements: 11-25%#LI-Hybrid

29 Blue Cross Blue Shield Association Jobs