Sr Project/Program Manager - Provider Network Strategy

Job Description

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.