Sr Project/Program Manager - Provider Network Strategy
Job Description
Leads and manages the day-to-day operational and tactical aspects of multiple or enterprise scale projects/programs, new initiatives and other ongoing business deliverables in accordance with business needs. Identifies, evaluates and resolves issues that conflict with project deliverables or program implementation. Collaborates closely with project team members, business owners and sponsors to develop and successfully implement projects/programs. Assesses project risks, develops mitigation and contingency plans. Oversees project to ensure projects have required resources, meets milestones and are successfully implemented. Leads and coordinates matrix and/or cross-functional team.
What You'll Do
Delegates work as required and ensures a quality end product through close customer contact and assesses customer/client satisfaction through direct feedback/evaluation.
Develop and manage program activities: defining goals and objectives, implementation strategies that align with organizational priorities, program evaluation and improvement.
Monitor all program project executions, progress to plan and production of major deliverables, intervening when necessary to review the current state and direct adjustments to plans and execution as needed.
Manage vendor relationships, negotiate, administer and monitor program contracts to ensure vendors meet service level agreements.
Provide clinical guidance and support to organizational initiatives that are utilizing and sharing enhanced data both internally & externally.
Establish and monitor key performance metrics and goals for programs, including process measures, outcomes measures and financial measures. Review program data results and compare with benchmarks.
Build & maintain internal and external relationships and clearly communicate complex information to diverse stakeholders.
Effectively manage and utilize resources across projects/programs.
Coordinates development and implementation of policies and procedures as well as development of compliance measurements. Controls and monitors project effectiveness; updates project plans as necessary. Ensures compliance with necessary audit requirements.
Ensure compliance with all applicable regulatory and accreditation standards and audit requirements.
Represents BCBSNC in meetings with external parties including consultants, vendors, and others and may include service delivery management of vendors.
Assists with data analysis and development of business processes to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met.
Develops escalation process to channel issues and concerns to appropriate parties.
Evaluates project/program risks, developing contingency plans and responding to change in risk as the project progresses.
Develops effective business process improvement initiatives and communication plans.
Performs analytic functions and coaches others in analytical production, technical and other areas.
Documents and presents project management results through the development of criteria, issue analysis papers and reports; ensures that projects established objectives such as financial goals, where applicable and creates an evaluation plan to assess project performance in relation to stated goals.
Develops and tracks budgets, operating plans and financial cost forecasts to support the objectives of the project.
Provides indirect reports, if applicable, with well-defined expectations, ongoing feedback, coaching/ mentoring and/or training.
What You'll Bring (Hiring Requirements)
Bachelor's degree or advanced degree (where required)
5+ years of experience in related field
In lieu of degree, 7+ years of experience in related field
Hiring Preferences
Registered Nurse with 7+ years of clinical experience
Experience in program and/or project management
Knowledgeable in healthcare quality measure and data
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
Based on annual corporate goal achievement and individual performance.
$75,900.00 - $136,600.00
Apply Now
Leads and manages the day-to-day operational and tactical aspects of multiple or enterprise scale projects/programs, new initiatives and other ongoing business deliverables in accordance with business needs. Identifies, evaluates and resolves issues that conflict with project deliverables or program implementation. Collaborates closely with project team members, business owners and sponsors to develop and successfully implement projects/programs. Assesses project risks, develops mitigation and contingency plans. Oversees project to ensure projects have required resources, meets milestones and are successfully implemented. Leads and coordinates matrix and/or cross-functional team.
What You'll Do
Delegates work as required and ensures a quality end product through close customer contact and assesses customer/client satisfaction through direct feedback/evaluation.
Develop and manage program activities: defining goals and objectives, implementation strategies that align with organizational priorities, program evaluation and improvement.
Monitor all program project executions, progress to plan and production of major deliverables, intervening when necessary to review the current state and direct adjustments to plans and execution as needed.
Manage vendor relationships, negotiate, administer and monitor program contracts to ensure vendors meet service level agreements.
Provide clinical guidance and support to organizational initiatives that are utilizing and sharing enhanced data both internally & externally.
Establish and monitor key performance metrics and goals for programs, including process measures, outcomes measures and financial measures. Review program data results and compare with benchmarks.
Build & maintain internal and external relationships and clearly communicate complex information to diverse stakeholders.
Effectively manage and utilize resources across projects/programs.
Coordinates development and implementation of policies and procedures as well as development of compliance measurements. Controls and monitors project effectiveness; updates project plans as necessary. Ensures compliance with necessary audit requirements.
Ensure compliance with all applicable regulatory and accreditation standards and audit requirements.
Represents BCBSNC in meetings with external parties including consultants, vendors, and others and may include service delivery management of vendors.
Assists with data analysis and development of business processes to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met.
Develops escalation process to channel issues and concerns to appropriate parties.
Evaluates project/program risks, developing contingency plans and responding to change in risk as the project progresses.
Develops effective business process improvement initiatives and communication plans.
Performs analytic functions and coaches others in analytical production, technical and other areas.
Documents and presents project management results through the development of criteria, issue analysis papers and reports; ensures that projects established objectives such as financial goals, where applicable and creates an evaluation plan to assess project performance in relation to stated goals.
Develops and tracks budgets, operating plans and financial cost forecasts to support the objectives of the project.
Provides indirect reports, if applicable, with well-defined expectations, ongoing feedback, coaching/ mentoring and/or training.
What You'll Bring (Hiring Requirements)
Bachelor's degree or advanced degree (where required)
5+ years of experience in related field
In lieu of degree, 7+ years of experience in related field
Hiring Preferences
Registered Nurse with 7+ years of clinical experience
Experience in program and/or project management
Knowledgeable in healthcare quality measure and data
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
Based on annual corporate goal achievement and individual performance.
$75,900.00 - $136,600.00
Apply Now