Resp & Qualifications
ESSENTIAL DUTIES AND RESPONSIBILITIES include, but are not limited to, the following:
Serves as subject matter expert, providing regulatory, technical and analytical guidance to projects resulting from Federal and/or State laws and regulations. Manages the full project management life cycle and technology changes for the day-to-day portfolio of projects Works with Mandates and SBU leadership teams to ensure all regulatory and business requirements are captured, and implemented accordingly. Keeps the Mandates and SBU leadership teams apprised of any risks, issues and dependencies and works with them to mitigate and prioritize. Provides both verbal and written communications regarding project status, risks, issues, and makes recommendations on project decisions to Senior Management.
Manages all aspects of the project/portfolio management of a the day-to-day projects, which may include: determination of regulatory requirements, cost benefit analysis, work plans, functional and technical designs, , testing and implementation. Monitors all technical aspects of implementing projects. Ensures associated business processes are documented and traceable back to the Project and Regulatory requirements.
Provides support to the IT Solutions Team in identifying the appropriate solutions required by the user areas; assists Leadership in performing a needs analysis of the relevant business areas and in matching user needs to system capabilities to ensure the capabilities are easily and quickly integrated into the client’s business environment. Provides oversight to testing resources assigned to projects. Works with Test Management to mitigate potential risks and project dependencies. Serves as a liaison between the mandates team, testers and developers to ensure cohesiveness between the teams.
Supervises and leads the project staff to oversee the impacts and interdependencies between Projects and works to ensure initiatives meet the CareFirst Goals and Objectives of the executive leadership team and ensure CareFirst achieves and maintains compliance against regulatory requirements. Perceived by peers and staff as a leader.
Works with the Business areas in the Operational Readiness activities to provide support and coordination to ensure adoption of new capabilities and business processes in the CareFirst environment. Ensures all regulatory requirements are specifically documented, associated to appropriate business/technical processes and appropriately understood by the receiving process owner.
Manages and directs multiple projects. Translates regulatory requirements and generalized customer business goals and objectives into concrete strategy and tactical plans. Works on complex problems where analysis of situation or data requires an in-depth evaluation of various factors to achieve best results. Evaluates complex situations accurately and identifies viable solutions that create successful outcomes for the customer.
Works effectively with internal and external clients, third party vendors, and Senior Management in accomplishing project objectives. Ensures all appropriate mandate project methodologies are followed to successfully implement projects. Resolves political, resource, budgeting, change, and legal issues affecting the projects.
Interpret and document state mandates implemented under day-to-day projects. Responsible for a full understanding of the regulatory foundation of projects and able to provide guidance to project managers as needed. Provide guidance to project teams and business partners to align regulatory requirements to operational requirements in a manner that balances cost and business needs to provide maximum value to CareFirst. Review interpretation and compliance documentation created by project managers prior to legal review.
Support internal and external policy decisions by providing sr. management with extensive analysis and recommendations on the operational impacts to CareFirst from external mandates, acting as a consultant at all levels to provide guidance. Provide concise status communications tailored to the appropriate audiences, as needed.
Manages Project Managers, Business Analysts and Technical Delivery Managers within assigned portfolio and/or project. Reviews staffing goals and expectations to ensure that each is consistent and adequate to meet department goals. Evaluates performance of direct reports, generates development plans and sets goals within the context of the corporate policy. Provides coaching, counseling and motivation to team members ensuring staff has the appropriate tools and training. Supervises matrixed resources, provides feedback and performance input where appropriate.
Assists in skills development and training assessments for the Program staff.
Makes recommendations on hiring, firing, advancement, promotional or any other change of status of Matrixed reports.
Proactively identifies risks and opportunities of both business and technical plans with specific emphasis on regulatory compliance; identifies Risk Mitigation Strategies and Contingency Plans for all identified Risks. Maintains the Portfolio Level issue and risk matrix log.
Provides a detailed plan of how the risk will be managed or eliminated. Provides a weekly Portfolio status report with major risk factors when mitigation approach impacts the project timeline, budget, or objectives. Coordinates the interdependencies and Risk Mitigation Strategy across all projects within the Portfolio and manages the execution within the individual projects.
This position is subject to level 6C security requirements.
Supervises and leads a team of matrixed reports consisting of:
Direct reports resources: 2-5; Project Managers and Business Analysts
Indirect reports/matrixed resources: 10-100; Project Managers, Technical delivery managers, Business Analysts, and other program staff in a matrix model
Vendor/Contractors: 10-80 Contractors and Vendor Consultants based on project needs against a Contract and Statement of Work, against a set of deliverables and defined payment milestones.
Required: Bachelors degree in Computer Science, Business, or equivalent work experience required. 8+ years of IT and business experience in strategic planning, development and implementation, preferably in health insurance or other regulated compliance environment. Previous technical project management experience in a dynamic high-technology environment and an understanding of the regulatory environment affecting health insurance business is a key to success in this position.
Out of the 8 years required, at least 5 years in a combination of the following:
Master’s degree in Business, Health Care, Public Policy or Technology related field. Prior Health insurance industry exposure; specific experience with successful large-scale Program Management within a cross functional environment. Previous experience managing staff preferred. PMP Preferred
Department: Mandates Implementation- MD
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Hire Range Disclaimer
Actual salary will be based on relevant job experience and work history.
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Please apply before: 12/5/2018
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
The physical demands described here are representative of those that must be met by an employee to perform the essential duties and responsibilities of the position successfully. Requirements may be modified to accommodate individuals with disabilities.
The employee is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The employee must frequently talk and hear. Weights of up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship