Resp & Qualifications
PURPOSE: This position is responsible for initiating, developing, analyzing, integrating and communicating information relating to various departments within the Division and Company. This position is responsible for creating new and maintaining existing reports on a pro-active basis. The position includes, but is not limited to, providing complex metrics, analyses, special projects and general enhancements to the betterment of Provider Contracting and Reimbursement. This position provides coordination with Managers and Associates by initiating, planning, developing communications and reporting activities. This position will focus on linking the diverse functions within Networks Management with company strategic planning, marketing efforts, financial goals and company initiatives in mind. This position reports to the Sr. Director, Provider Contracting and Reimbursement, Networks Management, but matrixed reporting relationships will occur, as needed.
PRINCIPAL ACCOUNTABILITIES: Under the direct supervision of the Sr. Director, the incumbent’s accountabilities include, but are not limited to, the following:
This position has no direct supervision of Associates,but may lead multiple project teams of 5-10 associates.
Required Experience/ Skills/Abilities:
• A four-year degree in a business or related area. In lieu of a degree, must have 4 years of related experience.
• 3-5 years of Provider Contracting and Reimbursement and/or Network development experience.
• 1-2 years of related project management experience in a large scale, cross functional, multi-system environment.
• Experience in managing several high priority tasks simultaneously.
• Ability to work proficiently with Microsoft Excel, Access, PowerPoint and Word.
• Flexibility and the ability to work under time constraints, adapt to shifting priorities, to work independently as well as part of a team.
• Excellent project management skills including but not limited to cost/benefit analysis, risk assessment, workplan development and management.
• Strong interpersonal skills and the ability to synthesize information quickly. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
• Excellent analytical, organizational and coordination skills.
• Effective presentation, negotiation and influencing skills to interface with all levels of management. The incumbent must be able to apply complex problem solving abilities to achieve problem and process solutions.
• Must be able to effectively work in a fast paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
• Master’s Degree in business or health care administration
• Working knowledge of NetworXPricer and Portico systems (as the source systems used within Networks Management for provider information).
• Knowledge of CareFirst’s provider networks and contracts
• Experience with Medicare / Medicaid programs
Department: Institutional Contracting - 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:4/01/2020
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 associate 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 associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship