Director, Inter-Plan Management (Blues Strategy)

Resp & Qualifications

PURPOSE:

The Director, Inter-Plan Management & Blue Strategy will be responsible for the BlueCard Program, liaising with other Blue Plans and Consortium Health Plans across the country, and will provide strategic direction on the future of Inter-Plan (Plan-to-Plan) engagement and Programs.


ESSENTIAL FUNCTIONS:

• Responsible for the BlueCard Program on a day-to-day basis and provides direction on the future of Inter-Plan Programs. Has the authority to activate decision-makers in all these areas, escalate issues for action and access subject matter expertise within their own Plans.
• Lead departments responsible for Inter-Plan Policy, Governance & Integration, Inter-Plan Data & Client Success, and Inter-Plan Sales & Pricing including BCBSA Workgroup, Blue Card Custom Pricing & Negotiations, Participate on Account-Specific Initiatives and Client-Facing engagements.
• Accountable for enabling national accounts sales growth. Make strategic and data-driven decisions. Responsible for operating plan development, goals, and results. Drive Blue Strategy for growth including ensuring that CareFirst is maximizing the value of the BlueCard Program for all constituents: internal Plan staff, other BCBS Plans, members, accounts and providers.
• Acts as the primary contact for BlueCard Program and related issues.  Liaise and build relationships with other Blue Plans and Consortium Health Plans across the country.
• Accountable for communications and decisions related to the BlueCard Program and other Inter-Plan functions & programs.
• Ensures that the Plan is maximizing the value of the BlueCard Program for all constituents: internal Plan staff, other BCBS Plans, members, accounts, and providers.

QUALIFICATIONS:

Education Level: Bachelor's Degree
Education Details: Business Administration, Health Administration or related field
Experience: 8 years Blue Plan or Health Plan Strategy experience
3 years management experience
3 years sales experience


In Lieu of Education

In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.


Knowledge, Skills and Abilities                                                         
Must have a strong understanding of inter-Plan programs and a broad understanding of Medicaid, senior market and other commercial group market and data initiatives                       

Additional Skills and Abilities

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. 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. 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.

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

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