CareFirst Careers

Manager, Technology & Special Projects

Resp & Qualifications

PURPOSE:  The CFA Manager of Technology & Special Projects is responsible for overseeing, enhancing, and implementing systems and operational changes sought or required by CFA, external partners, vendors, and the Blue Cross Blue Shield Association (BCBSA).  The Manager of Technology & Special Projects is accountable for systems process analysis, design and simulation with a focus on quality, process improvement and/or re-engineering, and maximizing operational efficiency and client and associate experience.  Guides activities such as identifying and recommending improvement opportunities, planning, budgeting, staffing, controlling, outsourcing and vendor management support, and project and systems change management.  Provides leadership and planning to ensure resources are leveraged to meet the company’s strategic objectives by reducing operating costs and improving service performance and delivery. 


PRINCIPAL ACCOUNTABILITIES

Oversees the day-to-day business technical support of systems and sub systems (including saleseforce.com) supporting sales and account management, claims, service, finance, enrollment, and membership within CFA in order to maintain a competitive edge in the marketplace and meet commitments to clients.  Designs and modifies system architecture and process mapping as necessary to support ongoing business and client needs and SBU’s strategic goals. Collaborates with CareFirst Information Technology unit to ensure IT and business alignment; directs extensive interface and collaboration between business and IT personnel to define, prioritize and plan implementation of projects as well as day to day change management as necessary to meet and exceed internal and external commitments.

Responsibilities include: analysis, development and resolution of enterprise-wide user or customer problems and enhancement change requests; monitoring systems effectiveness and its impact on desired levels of productivity and quality; represents NCAS/CFA interests on such matters with external parties (customers, vendors, partners, other Plans, etc); and maintenance of critical processing files. Promote and engage providers and vendors in electronic services adoption to increase SBU effectiveness.  Keep abreast of industry standards and competitive capabilities.

Oversees workgroups and all types of special projects for the SBU including but not limited to—process improvement, automation enhancements, salesforce.com, and other applicable projects that support a client-centric culture as well as the attainment of SBU goals.

Prepares and manages the strategic, tactical, and budgetary plans. Deploys resources as required to support new and renewal business demands. Facilitates, promotes, develops and provides guidance on policies and priorities as well as the enterprise’s human resources policies and values. Acts to resolve human resource issues and concerns that arise. 

Recruits and supervises staff and designs, implements and monitors staff performance and professional development plans.


SUPERVISORY RESPONSIBILITY:

Manages five to seven direct and indirect reports

QUALIFICATION REQUIREMENTS:

Required:

  • Bachelor’s Degree in an industry-related field and/or equivalent experience in the healthcare or similar industry and job function.
  • Two or more years of progressive management experience in an IT and/or operational environment
  • Proven experience to manage day-to-day functional/technical support and develop and implement departmental plans and projects to maintain and enhance related processes
  • Proven experience supporting and/or leading Systems Development Life Cycle activities and related Project Management activities/processes (CBAs, work plans, risk management, etc).
  • Proven experience negotiating, implementing/enhancing and managing external vendor partnerships
  • In depth understanding of claims processing, customer service and benefit provisions and effective working knowledge of enterprise-wide business functions
  • Experience interacting with VP/Director levels of management and their respective staff on a daily basis.


Abilities/Skills

  • Excellent written and oral communication and interpersonal skills
  • Must possess strategic thinking, analytical, organizational, and planning skills
  • Strong ability to lead others (direct and indirect) - motivate, negotiate, and persuade others
  • Ability to identify and manage numerous shifting priorities, deadlines and resource issues to achieve results


Preferred

  • Master’s Degree in Business, Info Systems or equivalent in healthcare or similar industry
  • e-Commerce experience

Preferred consideration will be given to candidates who have five or more years of experience with one or more of the following systems and or subsystems, or have an equivalent aptitude in similar systems:

  • Claims Adjudication Systems
  • EDI and HIPAA Administrative Simplification transaction standards
  • Web Portal technology
  • Call Center Technology
  • Data transmission standards
  • ANSI X12 N 837

#LI-CN1

Department

Department: Data Hub & Integration- 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

Closing Date

Please apply before: 10/31/2019

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.

PHYSICAL DEMANDS:

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

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