About Blue Cross
Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us.
How is this Role Important to Our Work?
This position supports the design, development, implementation, and evaluation of programs focused on improved CMS (Centers for Medicare & Medicaid Services) Star Ratings. Responsible for Medicare Star projects and programs, this position will work with leadership and cross-functional and cross-divisional teams to support the design and execution required to advance organizational or divisional strategic priorities. The incumbent will assist in the design process through implementation and outcomes measurement to ensure programs meet existing and emerging market, provider, and member requirements. The Senior Associate will work to find resolution of complex business issues, identify business opportunities/requirements, and help the business effectively manage change. Incumbent will be a part of program teams that cross the organization and manage through programs with tight deadlines. The incumbent serves as the liaison between multiple departments within the organization.
A Day in the Life
- Develop detailed strategies and workplans to influence the success for operational change and performance for assigned Star measures.
- Use evidence-based and multi-component approaches to program strategy, design, and execution.
- Drive the development and documentation of design, requirements, and key milestones of required tactics to support increased and sustained Star ratings that reach the organizational overall goal for assigned Star measures.
- Maintain strategic relationships and partner with key resources, both internal and external, to support the design and ensure market, member, and provider considerations are factored into the design. May include vendor oversight.
- Support the business decision making process to ensure capabilities, systems and processes meet market expectations and that alternate approaches are vetted and explored.
- Support the ongoing program management work of multiple programs to ensure the strategy is in alignment to solutions put forth through skills of influence.
- Manage and monitor multiple appropriate metrics, perform data analysis and evaluation for each initiative.
- Continually update program or project plans, timelines and deliverables while coordinating multiple sub-processes to expand and/or improve programs.
- Manage multiple communication plans in conjunction with leadership and to support initiatives, including status and progress updates.
- Stay abreast of changes in the rapidly evolving health care marketplace, including CMS regulatory changes, to define what successful measure performance looks like.
- May perform other duties as assigned.
Nice to Have:
- Bachelor's and/or master's degree in business, nursing, public health, health sciences, health promotion or related fields.
- Strong knowledge working with CMS Star Ratings measures (such as NCQA, HEDIS, CAHPS, PQA/Pharmacy, HOS, Operations, and CMS Display measures), as well as experience with the Medicare population preferred.
- Previous health plan experience.
- Experience in process improvement.
- Content expertise in the reduction of health risk behavior.
- Experience working in/with diverse racial or ethnic groups and nations.
- Ability to combine traditional health education approaches with policy or other advocacy tactics.
Required Skills and Experiences:
- 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
- Demonstrated organizational relationship management skills.
- Ability to thrive in ambiguity.
- Strong critical thinking skills and problem solving/conflict resolution skills.
- Excellent written and verbal communication skills with strong facilitation, negotiation, and presentation skills, adapting approach as needed.
- Attention to detail and time management skills.
- Self-motivated, ability to work independently, and demonstrated ability to work under tight time frames.
- Knowledge of the health care industry, payer business models, business segments and products.
- Proven ability to handle various assignments in a fast-paced and complex business environment.
- Proven ability to define problems, collect and analyze data, establish facts, and draw valid conclusions.
Make A Difference
Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.
Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.
All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.
Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
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