CASY-MSCCN Jobs

SUMMARY: The Program Manager, MA Association Programs is responsible for supporting the BCBSA Medicare Advantage Coordination of Care (OOA) program and other interplan projects. Duties associated with this position involve evaluation, implementation and monitoring overall program/project success of MA interplan programs and OOA related initiatives. The role will integrate, align and grow the capabilities of programs and work across business units and teams to identify opportunities, drive improvements and ensure program and project timelines are met. This role collaborates with multiple functional areas requiring a combination of focus and flexibility, as well as a willingness to play an active, behind-the-scenes role. The Program Manager exercises broad discretion and judgment in the acquisition and dissemination of information. The Program Manager understands multiple perspectives of health care, government programs, data exchange standards, nonprofit and for-profit business, operational issues and the impact. RESPONSIBILITIES/TASKS: * Manage plan-to-plan, vendor and internal communications to drive operational outcomes for the MA Coordination of Care (OOA) and other interplan programs. * Manage and maintain on-going data collection and file exchange efforts across the enterprise. * Plans, organizes, and directs activities of assigned initiatives and programs. Provides project coordination and management of on-going enhancements across the enterprise. * Evaluates interplan initiatives using a system of data collection & analysis to determine feasibility and effectiveness for go/no-go implementation decisions. * Leads program meetings and drives key decisions with all stakeholders to define project initiation requirements, ongoing monitoring, success criteria and facilitates conflict resolution and prioritization of implementation/production issues. * Drives key decisions with all stakeholders to define project/program initiation requirements, ongoing monitoring, and success criteria. * Establishes a refined body of metrics related to intake, execution, and delivery of initiatives in the clinical operations portfolio. * Works with project managers and business leads to develop business cases, understand project scheduling, outcomes and assure program objectives are met. * Maintains and provides information about current projects and potential future projects as required. * Manages vendor Statement of Work for adherence, renewal, and amendments. * Manages, in coordination with Finance and Accounting, program finances to include plan fee payments and financial reconciliation. * Identify, create, establish, and maintain reporting deliverables for budget, performance and project status. * Research and resolve discrepancies in existing reporting deliverables. * Clearly communicates policies and procedures as they relate to governance management and metric reporting. This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. EMPLOYMENT QUALIFICATIONS: EDUCATION: Bachelor's degree in Business, healthcare, or a related field. Master's degree in healthcare administration, business or public health is preferred. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. EXPERIENCE: * A minimum of seven (7) years of multi-faceted experience in the healthcare industry, project management environment or a related field with demonstrated technical knowledge that provides the necessary skills, knowledge, and abilities. * Prior electronic data exchange experience required. * Three (3) years of leadership experience in previous managed care or healthcare experience preferred. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: * Working knowledge of electronic data exchange concepts, interoperability mandates & standards,