CareFirst Careers

Sr. Project Manager - Networks Management

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:

  • Provides direction, prioritization and motivation to project team and department staff. Manages all phases of assigned tasks and/or project activities, which include monitoring progress, serving as resource to divisional management regarding the project, preparing reports for management, executive staff, various committees and Associate staff. Manages the work (task, sequencing, milestones, risk, and contingencies) to ensure that the work is launched on time and within all resource and time constraints.  Creates and reviews detailed plans to ensure that the implementation meets defined expectations and are in accordance with overall goals
  •  Actively involved in planning and monitoring the strategic goals of the department, Networks Management, and the Health Servicesdivision.  Participates in Corporate projects and leads meetings in order to ensure divisional goals and objectives are met, and that projects achieve and maintain optimum efficiency and satisfaction standards.
  •  Acts as a liaison across all areas internally including Finance, Health Services, Government Programs, Legal, etc., and externally to Vendors, Consultants, etc., to ensure effective and efficient goals, scope, progress, and completion of projects and provides management and oversight of many dynamic issues related to CareFirst maintaining a competitive advantage for provider cost and access.  Acts as the point of contact for the Provider Contracting and Reimbursement department.
  • Directs the investigation and assists in the resolution of any unusual trends or potential issues to assure data integrity and identify business issues, as appropriate. Responsible for developing, implementing and analyzing standard and ad hoc operational, financial and productivity metrics.  Manages research and other special projects and ad-hoc requests such as productivity analysis, variance analysis and trending or forecasting. 

 


SUPERVISORY RESPONSIBILITY:   
This position has no direct supervision of Associates,but may lead  multiple project teams of 5-10 associates.

QUALIFICATION REQUIREMENTS:
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.
In addition:
• 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. 

Preferred
• 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



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Department

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

Closing Date

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.

PHYSICAL DEMANDS:

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

Learn more about Medical Management