Blue Cross NC is a health insurance provider that focuses on improving healthcare delivery. The Sr Project/Program Manager will lead the design of population health strategy initiatives to enhance care coordination and health outcomes, while collaborating with senior leadership to monitor effectiveness and identify areas for improvement.
Responsibilities:
- Leads the development of population health strategies focused on advancing care coordination, improving health outcomes, and increasing program efficiency
- Gathers input from across the enterprise, division, community, members and through competitive intelligence to identify opportunities, assess needs and develop strategic design of solutions. Ensures alignment of solutions across the enterprise
- Develops business cases, strategy concept designs and program requirements. Serves as a subject matter expert, routinely briefing leaders and key stakeholders on program goals and initiatives
- Develops project plans and recommendations in support of compliance objectives and leads implementation. Tracks and reports on the status of projects. Assesses project risks, develops mitigation and contingency plans
- Identifies analyzes and understands target audiences and their specific program needs. Develops and deploys marketing strategy to increase member engagement in maternal health programs
- Leads vendor identification, evaluation, selection and contract negotiations for new vendor relationships
- Works with senior leadership team to support clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements
- May work across multiple Line of Business and states to encompass program needs into population health strategies
- Establishes and monitors performance metrics and goals for assigned programs, including process measures, outcomes measures, financial measures and methodologies for implementing programs. Documents and presents program results through operational reports, outcomes studies and presentations
- Owns and makes needed decisions to ensure the successful resolution of issues within the program to achieve milestones and program deliverables
- Incorporates evaluation planning into the overall strategy. Establishes key performance indicators for programs, including process measures, outcomes measures and financial measures. Ensure program is designed in such a way that these metrics can be collected and monitored
Requirements:
- Bachelor's degree or advanced degree (where required)
- 5+ years of experience in related field (strategic planning and program management for health plan)
- In lieu of degree, 7+ years of experience in related field
- Preference for a background in quality, public health, healthcare administration, business and/or clinical background