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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.Key responsibility for building and maintaining critical BCBS Plan/Client relationships with management staff responsible for operational performance of the Federal Employee Program (FEP). Plays a key role in providing strategic guidance, solving complex business problems and drive organizational efficiencies to improve Plan/Client operational performance. Serves as a trusted advisor to Plan/Client, providing insights and recommendations to Plans that drives to strengthen alignment with FEP strategic business objectives and goals. Influences and directs Plans/Clients to improve operational excellence and achieve critical business outcomes that positively impact Federal Employee Member satisfaction and overall Program performance. Collect, analyze and interpret client/Plan performance data to provide innovative and data-driven solutions, unique to client/Plan needs. Plans and executes Plan Training Townhalls/Conferences that promotes comprehensive understanding and knowledge of the Federal Employee Program and fosters government contracting compliance. Monitors and assess impacts of large-scale Program-wide projects to unique Plan/Client needs. Collaborate with Plan/Client leadership to understand business goals and develop annual business plans that support their Plan/Client administrative costs budget proposals and maximize operations performance. Acts as a resource for Plan Leadership and provides guidance when needed.Influences and manages Plans relationships:<ul><li>Drives operational excellence that aligns with FEP Strategy, achieving business success measures and driving Plan satisfaction.</li><li>Provides guidance and direction to Plans to implement performance improvements and program initiatives to affect change and consistently achieve excellent performance scores on PIP and member satisfaction.</li><li>Evaluates and analyzes Plans’ internal business processes, procedures and policies to identify opportunities for process and/or performance improvements that drives operational excellence and efficient business processes that have favorable impact on the Plans' efforts to manage FEP administrative costs.</li><li>Develops and executes Plan business strategies that are aligned with the Program strategy and objectives that drive operational excellence and cost efficiencies.</li><li>Continuously monitor Plans' performance to proactively resolve issues before impacting their performance.</li><li>Timely resolution of Plan questions and issues:</li><li>Accountable for ensuring timely and accurate resolution of Plan questions and issues relative to operational performance and contract administration.</li><li>Partners and collaborates with other BCBSA/FEP business units, including Program Integrity, Care Management, Provider Network Management, FEP Operations Center, etc., to resolve Plan specific and global issues related to the administration of FEP as defined by the OPM contract.</li></ul>OPM/CPR audit responsibilities:<ul><li>Provides direction and support to Plans to reduce operational audit findings identified in OPM and/or CPR audits.</li><li>Consults with Plans to implement process improvements to resolve and minimize recurring OPM and CPR audit findings and reduce Program risks relative to uncollected funds for benefits overpayments.</li><li>Collaborates with Program Assurance to coordinate activities to timely resolve audit issues affecting the Plans and financial exposure to the Program.</li></ul>Annual Conference accountabilities/Project Management<ul><li>Acts as business leads accountable for planning and executing the conferences and trainings that provide a venue for all Plans to meet with the BCBSA/FEP to exchange information, provide directional guidance, and address national issues in the contract administration of FEP.</li><li>Leads and facilitates the Operations Advisory Workgroup (OAWG), which is a cross-functional Plan advisory group accountable for providing the BCBSA/FEP with recommendations and feedback on claims, customer service, and care management initiatives and policies.</li><li>Leads, plans, and executes Plan training that provides education and direction to Plans’ new management and staff responsible for FEP business functions.</li><li>Conducts and leads FEP Core Business Initiatives critical to the operations of the Program. (SC Plan and FEPOC Business Portability, FEP Business Contingency).</li><li>Provides business expertise on cross-functional projects/committees to provide guidance on issues impacting local Plans and to address/mitigate any potential adverse impact on Plans and the Program.</li></ul>Education Bachelor’s degree in business or a related discipline, or equivalent years of related experience Certifications Experience<ul><li>5+ years’ work experience, with in health insurance operations.</li></ul><ul><li>Advance experience and understanding of health plans' operational business procedures/processes.</li></ul><ul><li>Extensive experience with account/relationship management with the ability to maintain strong business relationships.</li></ul><ul><li>2 or more years’ experience working as FEP Plan leadership, in Operations with demonstrated outstanding performance.</li></ul> Skills<ul><li>Superior relationship management skills with demonstrated ability to maintain strong relationships with key with business partners.</li></ul><ul><li>Demonstrated comprehensive understanding of BCBS Plans’ FEP operations.</li></ul><ul><li>Exceptional negotiating skills with the ability to influence Client/Plans’ behavior to drive business objectives.</li></ul><ul><li>Advance analytical and conceptual skills with ability to analyze and resolve problems/issues timely and accurately.</li></ul><ul><li>Advance negotiation and strategic thinking skills with the ability to influence Client/Plans’ behavior to drive Program success.</li></ul><ul><li>Analytical skills with ability to identify and prioritize critical business issues.</li></ul><ul><li>Exceptional presentation skills and experience presenting to various size groups.</li></ul><ul><li>Excellent communication skills, both oral and written.</li></ul>People Management No#LI-Remote

Blue Cross Blue Shield Association

Sr Plan Manager Ops

The hiring range for this role is: &nbsp;$160,000.00 - $220,000.00This 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: This role is responsible for the leadership and delivery of advanced architecture solutions, standards, and processes to meet the needs of the Association and Blues System. Provides strategic and tactical oversight over the evaluation and adoption of emerging technologies to optimize BCBSA business strategy and initiatives. Manages the implementation of architectural processes, practices and governance across all BCBSA technical teams. Partners with business and technical leaders to improve the multiyear technology roadmap and transparency of total cost of ownership to influence strategic IT investments.Responsibilities include but are not limited to:<ul><li>Provides direction for BCBSA technical architecture across all domains (business, information, application, technology) and across all organizational teams. Develops and communicates a strategic vision for BCBSA enterprise architecture working with senior management to articulate the vision to BCBSA staff and customers. Defines enterprise technology strategy and roadmaps including multi-year implementation planning of strategic initiatives in cross-divisional collaboration.</li><li>Provides oversight of emerging technologies to enhance business capabilities and drive innovation. Ensures assessments of new technologies conducted to ensure alignment with organizational goals and cost-efficiency. Partners with leadership to advocate adoption of successful solutions</li><li>Provides strategic leadership regarding technological changes to support business requirements. Ensures the architecture community creates/maintains high quality products, maximize reusability/sharing of components and technical assets, and do so on time.</li><li>Lead and manage a team with the aim of driving effective performance management, fostering professional growth, and creating a positive and inclusive work environment. This role is dedicated to utilizing strong leadership and communication skills to motivate and inspire team members, ensuring they are aligned with and committed to achieving the organization’s goals.</li></ul>Required Education, Experience, and CertificationEducation:<ul><li>Required: Bachelors Degree</li></ul>Experience:Required:<ul><li>A minimum of 10 years IT experience focused on the architecture, design, implementation, and deployment of large-scaled integrated information technology solutions platforms</li><li>Multiple years of people management</li><li>Experience with financial oversight of budgets and forecasts.</li></ul>Preferred:<ul><li>Applicable experience in health insurance technology</li></ul>Knowledge, Skills, and Abilities<ul><li>Strategic leadership abilities to work across technology and business, building strong and enthusiastic relationships to achieve desired outcomes.</li><li>Excellent oral and written communication skills with the ability to negotiate, persuade, and make effective presentations to varying audiences internal and external to BCBSA.</li><li>Expert technical acumen with the ability to think creatively and strategically to capitalize on business efficiencies.</li><li>A high level of confidence, integrity, and critical thinking skills, establishing credibility and decisiveness while balancing varying business considerations/priorities.</li><li>Works effectively in a highly matrixed IT environment while maintaining balance between team goals and overall business unit goals.</li><li>Ability to develop and implement strategies for achieving business objectives</li><li>Ability to organize and manage multiple priorities.</li><li>Professional executive presence for interacting with and influencing key leadership and decision makers within the BCBS system, as well as with external stakeholders preferred.</li><li>Strong client consultative skills through internal or external consulting experience.</li></ul>Revenue Responsibility: NoBudget Responsibility: YesPeople Management: Yes#LI_HYBRID

Managing Director, Enterprise Architecture

The hiring range for this role is: &nbsp;$120,000.00 - $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.Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs — ones that are injected or infused by a health care professional in a clinical setting — for nearly 100 million Americans. The Senior Applied Analytics Analyst will provide business analytics for new product development, product and program evaluation, client consultation and benefit plan analysis. This position will drive the process of combining business knowledge and quantitative analysis to identify business value opportunities for Synergie Medication Collective and our clients. The Senior Analyst may work directly with Synergie Medication Collective’s leadership team and clients and provide consultation for plan analytics and new products or strategies.Execute department-specific reporting and work with users and project teams to define new capability and report Requirements Verify the integrity of data, including data extraction, storage, manipulation, processing and analysis Consolidate large data sets from a variety of sources to support specific business analysis efforts, identification of enhancements or solutions, and the prioritization of ad-hoc data and project requests Support client consultation by providing required data, conducting analysis and participating in the development of client Provide subject matter expertise to Applied Analytics team and business partners on analytic projects; ensure the appropriate Work directly with clients and internal partners to provide consultation, analytic insight, and strategy, as well as produce data, models and analytics as required Leverage statistical and other data analysis methods to identify quality issues and possible solutions or process Other duties as assignedEducation Bachelor’s degree in Mathematics, Finance, Business or related field, or the equivalent combination of education and/or relevant work experience; HS diploma or GED is required.Additional experience PBM or healthcare experience• Prior experience with statistical modeling and/or predictive modeling• Experience working with an enterprise level data warehouse• Project implementation experience Experience Data management, data analysis, and/or report development experience with at least 3 years working with benefit plan data, metadata and/or conducting data quality monitoring working with data visualization tools and techniques SAS, SPSS, SQL, SXC or other data analysis tools People Management No#LI_REMOTE

Applied Analytics Analyst - Synergie Medication Collective

The hiring range for this role is: &nbsp;$160,000.00 - $190,000.00This 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.Synergie Medication Collective is looking for an experienced Senior Director of Engineering to lead our engineering, infrastructure, and security functions and support our company’s technology strategy. This role goes beyond traditional infrastructure and security management to include a broader focus on engineering leadership, supporting both infrastructure and product development initiatives. The ideal candidate will bring engineering expertise, leadership experience, and the ability to work effectively across teams and levels within the organization.Key Responsibilities:Develop and maintain standards and best practices across engineering, infrastructure, and security, working closely with the Head of Technology.<ul><li>Oversee day-to-day execution of engineering efforts across infrastructure, security, and product development to meet business needs.</li><li>Actively engage in the execution of engineering efforts, providing direct technical support, troubleshooting, and guidance to ensure successful outcomes.</li><li>Architect and implement secure, scalable infrastructure solutions aligned with organizational needs.</li><li>Manage security controls and compliance standards (SOC2) to ensure they are integrated into all aspects of our engineering practices, from design to deployment.</li></ul>Qualifications:<ul><li>Strong expertise in architecting solutions and hands-on execution within complex, fast-paced environments.</li><li>Proven track record of cross-functional collaboration, with the ability to work effectively with stakeholders at all levels.</li><li>Demonstrated leadership skills, with experience managing and mentoring technical resources.</li><li>Ability to combine strategic vision with hands-on engineering, enabling effective collaboration with both technical and non-technical stakeholders.</li><li>Proficiency in cloud platforms (AWS, Azure, GCP), with experience leveraging these tools to support business objectives.</li></ul>#LI_REMOTE

Sr Director Engineering - Synergie Medication Collective

The hiring range for this role is: &nbsp;$150,000.00 - $180,000.00This 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 Lead Security Engineer supporting the Vulnerability Management domain plays a vital role in safeguarding the organization's technology assets by developing and implementing a comprehensive program to identify, assess, and rectify vulnerabilities in both production and enterprise assets. This role ensures that identified security vulnerabilities are promptly addressed and requires a strong understanding of cybersecurity, risk management, compliance, and involves collaborating with cross-functional teams. This role is crucial in safeguarding systems and pushing the boundaries of vulnerability management. This role brings technical expertise in Vulnerability Management to protect the organization’s information systems and data. This role's proficiency extends beyond technical expertise to include vulnerability management leadership in risk analysis, creating dashboards, visualization, and executive reporting. Additionally, this role needs to understand security controls and regulatory compliance frameworks such as NIST, ISO, HITRUST, and HIPAA.Responsibilities include but are not limited to:<ul><li>Provide strategic and operational leadership in a specific security domain/program and manages multiple projects related to it.</li><li>Cross-functionally partner with key stakeholders and other teams to enhance our overall security posture, align security efforts with business objectives and facilitate communication between technical and non-technical stakeholders.</li><li>Generate roadmaps, drive operational excellence, optimize costs, and enhance security risk visibility.</li><li>Establish frameworks for best practices, define OKRs and KPIs, and deliver reports on relevant metrics and compliance</li><li>Participate in domain related incident response efforts as needed, maintain defined security architecture, and manage domain specific security tools.</li></ul>Required Education, Certifications and Experience<ul><li>High School Diploma/GED</li><li>Bachelor’s degree in Computer Science, Information Technology, or related field or equivalent experience.</li><li>Minimum 7 years of information security experience.</li><li>Experience implementing risk remediation prioritization and collaboration with key stakeholders to understand risk drivers and remediation blockers.</li><li>Experience building and maintaining a comprehensive domain specific security program, developing policies and guidelines, collaborate cross-functionally, aggregate results, prioritize data, and facilitate remediation plans where needed.</li><li>Experience monitoring and tracking remediation efforts, staying abreast of emerging threats, and leading the design, implementation, and maintenance of domain specific toolsets.</li><li>Excellent communication skills</li><li>Excellent presentation skills that cater to technical and non-technical audiences.</li><li>Strong analytical and problem-solving skills and ability to manage multiple projects successfully, ensuring timely and budget-friendly completion.</li><li>Strong interpersonal skills, and the ability to influence and solve problems effectively.</li><li>Solid understanding of HIPAA/HITRUST requirements, cloud-first security practices, and various security tools and technologies.</li><li>Proficiency in scripting languages (preferably Python), API integrations, and process automation (for Vulnerability Management domain)</li></ul>Preferred Education, Certifications and Experience<ul><li>Certified Information Systems Security Professional (CISSP)</li></ul>People ManagementNo#LI-HYBRID

Lead Security Engineer (Vulnerability Management)

The hiring range for this role is: &nbsp;$173,000.00 - $185,000.00This 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.Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs — ones that are injected or infused by a health care professional in a clinical setting — for nearly 100 million Americans. The Sr. Director, Trade Relations of Synergie Medication Collective, in collaboration with the Head of Trade Relations and Chief Trade Relations Officer, will negotiate contracts and maintain relationships with pharmaceutical manufacturers for the GPO. The Sr. Director will have significant experience in negotiating contracts and relationship management with pharmaceutical manufacturers. The SME will work to leverage the assets that currently exist within the Blue System and work with peers of a larger organization to maximize scale in support of driving better costs for members. This position will report to the Head of Trade Relations Officer and will be a critical member of the trade team. This initiative is nothing less than transformative, with the goals of positioning the BCBS health plans to deliver on the quadruple aim in health care (service, access, quality, and affordability). We are looking for someone passionate about transforming health care, building and growing an organization and collaborating on future innovation.Job Responsibilities include but are not limited to:<ul><li>Partner with Synergie teams to develop, review, and align strategies and negotiate with pharmaceutical manufacturers; collaborate on rebate bid analysis and rebate agreement process to ensure alignment with corporate goals, performance standards and expected outcomes</li><li>Partner with the Head of Trade Relations and Chief Trade Relations Officer in the development and implementation of strategic initiatives and collaborate with key internal teams to create program/product value to clients, members, providers, and pharmaceutical manufacturers</li><li>Work closely with Synergie teams, related to medical policy and drug list development, pharmaceutical manufacturer programs and contracts, and ongoing evaluation of drug therapy classes for rebate and other financial opportunities; ensure effective communication and strategic collaboration within GPO</li><li>Represent Synergie’s objectives and perspective to external partners (i.e., pharmaceutical manufacturers, clients, others) and communicate to ensure understanding of mutual objectives</li><li>Ensure manufacturers’ products are brought forth internally to evaluate rebate and management opportunities for Synergie’s business</li><li>Serve as a department resource for escalated client issues, contract analysis, and contract language needs in rebate contracting</li><li>Represent Trade Relations on committees to identify effective net-cost policy opportunities; support client alignment and adoption of strategies; ensure communication with committee members</li><li>Other duties as assigned</li></ul>Required Education, Certifications, and Experience:<ul><li>Bachelor’s degree in business, healthcare management or other related fields of study or equivalent combination of education and/or related work experience; HS diploma or GED is required</li><li>10-15 years of related work experience in pharmacy benefit management (PBM), pharmaceutical payer contracting, and/or analytical contracting</li><li>Must be eligible to work in the United States without need for work visa or residency sponsorship</li><li>Excellent verbal and written presentation skills</li><li>Ability to establish rapport and build relationships at all levels within an organization</li><li>Expert negotiation and influencing skills</li><li>Strong business and financial acumen, with advanced proficiency in Excel and PowerPoint</li></ul>Preferred Qualifications:<ul><li>MBA, other graduate work, or equivalent training and/or experience</li><li>Experience within the PBM industry, Medicaid, Medicare, and health plans</li><li>Experience with contract language and risk mitigation concepts</li></ul>Minimum Physical Job Requirements:<ul><li>Ability to travel up to 15% of the time</li><li>Constantly required to sit, use hands to handle or feel, talk and hear</li><li>Frequently required to reach with hands and arms</li><li>Occasionally required to stand, walk and stoop, kneel, and crouch</li><li>Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds</li><li>Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus</li></ul>Reporting Structure:<ul><li>Reports to the Head of Trade Relations Officer</li></ul>#LI_REMOTE

Sr Director Trade Relations - SMC

The hiring range for this role is: &nbsp;172,036.00 - 241,270.00This 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 Senior leader to advance BCBSA’s legislative and regulatory policy solutions and market positioning in Medicare, Medicaid, Duals, and Children's Health Insurance Program, impacting the tens of millions of Americans we cover, serve, and support in these programs. This role will be a critical policy voice on the most pressing policy issues, serving as a lead advocate for government programs with lawmakers, regulators, BCBS companies, coalitions, industry partners, and media. Leads the development of consensus positions with member plans and a broad range of advocacy materials. Manages a creative team of dynamic experts to deliver strong results.Responsibilities include but are not limited to:<ul><li>Set Strategy – Senior leader to collaboratively drive the strategic policy and positioning on Medicare, Medicaid, Duals, and CHIP to engage, inform, and persuade decision-makers in Congress and the Administration on the most effective solutions. Examples include Medicaid redeterminations, Medicaid managed care, MA rate notice, CMMI demonstrations, and aligning private-sector initiatives with public programs.</li><li>Develop policy – Develop consensus positions among BCBS companies on federal legislation and regulations, from long-term, proactive solutions to real-time, reactive perspectives. Coordinate with senior leaders across member plans, teams and departments to ensure holistic policy alignment and comprehensive solutions, including lobbying, communications, research, marketing, legal, and business teams.</li><li>Resources/research – Lead the development and management of impactful materials and resources that demonstrate our commitment to public programs and advance our policy objectives, including large-scale research, actuarial modeling, cost estimates, case studies, bill summaries, legal opinions, testimony and letters to Congress, the Administration and state officials.</li><li>Advocacy – Leading voice with Administration officials to improve federal rules and regulations affecting Medicare, Medicaid, Duals, and CHIP. Work in close partnership with lobbying team to support congressional education and engagement, including federal lobbying activities on Capitol Hill, as well as with state officials focused on Medicaid solutions.</li><li>Plan Engagement – Senior communicator and key contact with BCBS companies across the country to build strategic alignment and educate on often complex policy issues.</li><li>Professional network - Maintain strong network of contacts to strengthen ongoing relationships to advance policies. Plays a leadership role in working with industry partners and influential third-party stakeholders, including coalitions and campaigns. Serve as liaison with regulatory representatives from other associations in the health sector.</li></ul>Required Education, Certifications and Experience:Education:<ul><li>Bachelors Degree – required; Bachelor’s Degree in Political Science, Public Health, Public Administration or related field</li><li>Masters Degree – preferred; Master’s Degree in public policy, health policy or related field</li></ul>Experience:<ul><li>8-10 years of working with federal legislation, regulation and government programs</li><li>3-5 years of experience with staff management and development</li><li>Must have extensive experience and exposure to broad-based government programs (Medicare and/or Medicaid/CHIP) and health care insurance issues including the legislative and political process and environment, and an understanding of the factors affecting legislative policy developments.</li><li>Experience developing consensus positions and advocacy strategies for adoption of organization recommendations.</li><li>Experience leading a cross-functional team on policy development, strategy, research and modeling projects to identify complex financial issues and/or advocacy opportunities.</li><li>Experience working with a health plan strongly preferred.</li></ul>#LI_HYBRID

Executive Director, Legislative and Regulatory Policy - Medicare

The hiring range for this role is: &nbsp;$150,000.00 - $210,000.00This 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.Supports the SVP and Commercial Markets / Enterprise Data Services Leadership team, enabling the team to fulfill their commitments to our internal stakeholders and Plans. This is a highly strategic, collaborative and facilitative role that requires a combination of focus and flexibility, as well as active, behind-the-scenes leadership. As the SVP’s trusted counsel, the role requires a highly- resourceful and organized individual with emotional intelligence, self-motivation, resilience, and strong analytical and communication skills. Serves as a critical resource in the implementation of key strategic, operational and organizational improvements across teams. The leader plans and directs all administrative, financial, and operational activities for the SVP across CM and EDS Departments. Organizes and prioritizes critical issues and required information for the SVP to facilitate efficient decision-making and strategic prioritization. Acts as a point of contact between individual Department leadership, the BCBSA Officer and Senior Leadership teams, and other stakeholders. Provides oversight, guidance and occasional direct leadership to projects of high importance. Responsible for creating and maintaining efficient and streamlined processes for the collection and analysis of required information from CM/EDS stakeholders. As a result of this work, administrative time incurred by the SVP and other CM/EDS leaders and stakeholders is minimized or eliminated. Responsible for oversight of the Commercial Markets and Enterprise Data Solutions budget at the portfolio level, in partnership with the Association finance team. Manages team expenses within approved budget and support the decision making process for reallocation or funds within the CM/EDS portfolio as appropriate. Works with other stakeholders to prepare the annual budget, provide periodic forecasts and monitor variances. Develops and executes an organizational development and engagement strategy that’s aligned to BCBSA and CM/EDS priorities, driving employee engagement across all 4 Departments and all levels through multiple programs and channels. Proactively identifies issues that could impact the successful execution of the SVP’s commitments: This responsibility involves elevating those issues about which the SVP should be aware is among the most challenging aspects of the job and will require the ED CM Administration to focus on the underlying interests of the parties working with the SVP, to creatively alternative means of handling pressing issues. Responsible for successful stakeholder engagement and effective, efficient, timely communications with internal partners and external customers to support strategic and operational priorities. This role requires extensive collaboration skills and ability to negotiate win-win scenarios. Works effectively in a matrixed cross-functional technology and project management environment while maintaining balance between team goals and overall CM/EDS goals. Will be assigned to lead, and work on cross-functional teams, solving our biggest problems through collaborative and driven leadership at all levels across CM/EDS. Why Team BCBSA? Play a critical role in shaping and executing impactful initiatives.&nbsp; Have an opportunity for creativity in addressing complex issues and have an opportunity to lead cross-functional teams, solving challenges together.&nbsp; 401(K) with Company Match-helping you make a good financial decision today and for the future.Primary Job FunctionsPlanning and Budget<ul><li>Establishes Market Solutions strategic planning processes in support of the BCBSA Annual Corporate Goals and budget, as well as multiyear plans. Develops and maintains the Market Solutions budgeting processes, to both ensure transparency to business leaders and implement flexible solutions to changes in business demand.</li><li>Oversees the high-level management of and reporting for the teams’ strategic initiatives across the Market Solutions. Tracks and monitors performance against Market Solutions annual goals, coordinating across the department leadership team and with strategic partners.</li><li>Determines, in partnership with the EPMO, the approach to management of the Market Solutions portfolio, including project intake, prioritization, approval, and capacity/resource assignment.</li><li>Provides independent leadership of special SVP-initiated projects, ranging from critically important strategy decks to confidential or time-sensitive issues.</li></ul>Governance Planning and Oversight<ul><li>Drives Market Solutions governance engagement and planning, facilitating agenda planning and development for BCBSA Board Committees and Subcommittees in a highly collaborative environment, coordinating with business owners and with cross-functional stakeholders.</li><li>Serves as primary liaison with the Governance team.</li><li>Provides strategic guidance and education to Market Solutions team members on briefing and pre-read materials for BCBSA Board, Board Committees, Subcommittees and other critical governance committees through thoughtful engagement, demonstrated business acumen and influence.</li></ul>Organizational Development and Engagement Support<ul><li>Develops and executes the Market Solutions culture activities and team engagement strategy that’s aligned to BCBSA and Market Solutions priorities; driving employee engagement through multiple channels, including team meetings, digital engagement, activities.</li><li>Coordination and support of initiatives, in partnership with the HR business partner, to ensure Market Solutions-wide alignment and compliance with Association personnel policies and approaches. Educates Market Solutions leaders and staff on resource utilization; workforce management, skills matrix, training, onboarding in partnership with the Human Resources business partner</li><li>Supports audit, policy compliance, and legal inquiries on behalf of SVP and Market Solutions organization and manages responses, remediation plans.</li><li>Assists SVP in prepping strategic communications for internal (e.g., monthly newsletter) and external audiences (e.g., National Customer Advisory Council).</li><li>Coordinates internal team events, forums: prepares agendas, presentations, facilities, attendees, budget, etc. and supports creation of all materials and organization of Market Solutions-wide resources to do so.</li></ul>Plan Communications and Relations<ul><li>Guides Plan engagement efforts including stakeholder strategies, Plan education and training on behalf of the Market Solutions department.</li><li>Oversees Market Solutions communication vehicles, including newsletters, BlueWeb content, webinars, meetings, and conferences.</li><li>Serves as a primary liaison on behalf of the SVP and Market Solutions leadership team with conference services for planning and execution of large scale Plan educational sessions and best practice sharing efforts.</li></ul>Education, Experience, and CertificationEducation Required: Bachelors DegreeExperience Required: 10 years' management experience with demonstrated knowledge of strategic planning and experience developing and implementing strategies and business plans for achieving business objectives and organizing and managing multiple priorities. Supervisory or management experience in an information technology department.Knowledge, Skills, and Abilities<ul><li>Management experience</li><li>Extensive collaboration skills and ability to negotiate win-win scenarios. Works effectively in a matrixed, cross-functional technology and project management environment while maintaining balance between team goals and overall Market Solutions goals.</li><li>Knowledge of strategic planning and experience developing and implementing strategies and business plans for achieving business objectives and organizing and managing multiple priorities.</li><li>Professional executive presence for interacting with and influencing key leadership and decisionmakers</li><li>Extensive collaboration and negotiation skills</li><li>Relationship management skills</li><li>Financial acumen</li><li>Project/portfolio management skills</li><li>Organizational development and design skills</li><li>Communication skills</li><li>Relevant technology skills</li><li>Critical thinking skills</li><li>Excellent interpersonal skills for building and fostering key relationships</li><li>Highly skilled in planning and delegating multiple high-impact, large-scale, complex projects.</li><li>Strategic leadership abilities to work across teams, building strong and enthusiastic relationships to achieve desired outcomes.</li></ul> Financial Responsibilities Financial Management: NoBudget Management: YesPeople Management: Yes Yes#LI-Hybrid

Executive Director,  Market Solutions Administration

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

Medical Director, Medical Affairs

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

27 Blue Cross Blue Shield Association Jobs