Affordability Program Manager
| Company | Blue Cross Blue Shield |
|---|---|
| Location | Phoenix, AZ, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- 5 years of experience in analytical, actuarial or business analysis role
- 5 years of experience working for a healthcare organization / health insurer
- Bachelor’s Degree in general field of study
- Intermediate PC proficiency
- Intermediate proficiency with Microsoft Office, including Excel, Word and PowerPoint
- Intermediate proficiency with Tableau or other data visualization tools
- Excellent presentation and communication skills
- Strong research and organization skills
- Advanced analytical and problem solving skills necessary to generate insights and recommendations based on available data
- Ability to recognize strategic opportunities and use data to make timely and sound decisions
- Excellent professional and interpersonal skills, including the ability to collaborate with team members and business stakeholders at all levels of the organization
- Advanced project management experience
- Flexibility and willingness to adjust to shifting demands/priorities
- Strong customer service skills
- Ability to make decisions in a timely manner, sometimes with incomplete information and under tight deadlines
- Ability to maintain high standard of performance while pursuing aggressive goals
- Ability to influence key stakeholders to accomplish key objectives
- Ability to maintain confidentiality and privacy
- Principled leadership and sound business ethics
Responsibilities
- Lead Segment specific cost of care efforts in identification, evaluation, implementation and monitoring of affordability and quality improvement initiatives designed to optimize the cost of high-quality medical care and achieve Segment specific Cost of Care savings targets.
- Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and validate trends, advising Growth and Segment leadership team of affordability challenges and potential mitigating actions.
- Partner with other Cost of Care Workstreams to identify and implement Affordability Initiatives (Network, Clinical, Pharmacy, Value Based Care, Payment Integrity, Vendor Partnerships, etc.)
- Develop business cases related to Segment cost of care initiatives to support Leadership decision-making and prioritization of opportunities based on balancing organizational alignment, ROI and resource constraints.
- Provide leadership and segment representation on corporate committees, advocating for customer needs and effectively communicating decisions and actions to segment leadership.
- Monitor external economic and healthcare issues affecting cost and utilization trends impacting the industry, the organization, and the segment.
- Prepare fact-based analysis and strategic recommendations to drive development of new/modified provider networks, including potential impacts of provider risk sharing as appropriate.
- Partner with Analytics and Provider Network teams to identify providers and locations practicing high value care for inclusion in current or future Exclusive Network offerings.
- Lead segment in Value-Based Partnerships, ensuring appropriate information sharing and monitoring outcome metrics in order to drive improved segment affordability and pricing predictability.
- Actively engage in Segment Departmental and General Manager meetings to ensure alignment with Segment Priorities and socialization of Cost of Care initiatives.
- Build and maintain effective working relationships with internal stakeholders and key external contacts to ensure teamwork in achieving corporate goals.
- Participate in strategic planning activities and contribute to departmental and cross-functional teams to achieve BCBSAZ goals and ensure future success.
- Drive performance through management and execution of organizational plans and activities.
- Coordinate activities between multiple divisions to achieve desired results.
- Perform all other duties as assigned.
Preferred Qualifications
- 5 years of experience in analytical, actuarial or business analysis leadership role
- 7 years of experience working for a healthcare organization / health insurer
- Bachelor’s Degree in Business, Healthcare, Mathematics, Economics, Finance or related field of study.