Network Design & Discount Director (Job Number:11679)
Description
Summary:
This highly strategic position is responsible for creating a competitive advantage through network design and discount analysis. The Director is responsible for innovations and the strategic development of Blue Cross’ provider network designs including designing and implementing differentiating network configurations and developing innovative contracting arrangements to support new network designs. This position is also responsible to capitalize on all aspects of data submission relative to discount positioning to drive the positive positioning of networks in external discount analysis. This position is a key member of the Provider Relations management team and leads the creation and positioning of differentiated network designs and discount analysis.
Accountabilities:
1. Develops differentiated networks that provide competitive cost, access and value to customers and members evolving the network designs from wide open access to networks that are differentiating.
2. Leverages Blue Cross’ knowledge of provider performance to create value based networks that accomplish the triple aim of lower cost, higher quality and better member/patient satisfaction.
3. Provides strategic direction to create, socialize and develop market leading value networks through synthesis of national, local and industry best practices.
4. Collaborates with Provider Relations’ leadership to develop strategies and payment methods to support evolving network designs.
5. Works with sales /product leadership to leverage new network designs in product development and sales educational resource to develop sales training and materials for sales staff to use in selling the value of new network designs.
6. Provides insight, overview and direction on our financial submissions to BHI, Milliman and the Consortium to ensure market competitiveness.
7. Capitalizes on data requirements to ensure all aspects of the data are being optimized for discount analysis.
8. Acts as the key focal point for all questions, submission and analytics related to discount analysis reporting and submissions.
9. Manages the department including interviewing and hiring employees following required EEO and Affirmative action guidelines and ensuring employees receive proper training. Conducts performance evaluations, and is responsible for managing employees, including skill and career development, policy administration, coaching on performance management and behavior, employee relations and cost control.
The job description in not intended to be an exhaustive list of all functions and responsibilities of the position. Employees are held accountable for all functions of the job. Job duties and the % of time identified for any function are subject to change at any time.
- Work is performed in an office setting
- In-state and out-of-state travel occasionally required
- Required travel between Eagan campus building locations
Qualifications
Required Qualifications:
- Accepting this director level position at BCBSMN requires signing an Agreement Regarding Non-Disclosure of Confidential Information and Non-Competition as a condition of employment.
- Bachelor’s degree in business, healthcare administration or related field and at least 7 years’ experience in Network Management for a health plan
- Strategic vision combined with operational excellence, thinks strategically and implements tactically to consistently deliver results
- Leadership skills that demonstrate the ability to lead people and get results through others
- Excellent business execution skills to drive for results
- Ability to work independently and to make sound business decisions.
- Strong business and financial acumen
- Demonstrated ability to use data to drive results on a large scale.
- Advanced interpersonal skills and the ability to build relationships with and to influence a wide variety of internal and external stakeholders.
- Highly creative and resourceful with the ability to effectively identify, collect, analyze and interpret data to create a market leading discount position
Blue Cross Blue Shield of Minnesota 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, or any other legally protected characteristic.
Primary Location: United States-Minnesota-Eagan
Shift: Day Job
Description
Summary:
This highly strategic position is responsible for creating a competitive advantage through network design and discount analysis. The Director is responsible for innovations and the strategic development of Blue Cross’ provider network designs including designing and implementing differentiating network configurations and developing innovative contracting arrangements to support new network designs. This position is also responsible to capitalize on all aspects of data submission relative to discount positioning to drive the positive positioning of networks in external discount analysis. This position is a key member of the Provider Relations management team and leads the creation and positioning of differentiated network designs and discount analysis.
Accountabilities:
1. Develops differentiated networks that provide competitive cost, access and value to customers and members evolving the network designs from wide open access to networks that are differentiating.
2. Leverages Blue Cross’ knowledge of provider performance to create value based networks that accomplish the triple aim of lower cost, higher quality and better member/patient satisfaction.
3. Provides strategic direction to create, socialize and develop market leading value networks through synthesis of national, local and industry best practices.
4. Collaborates with Provider Relations’ leadership to develop strategies and payment methods to support evolving network designs.
5. Works with sales /product leadership to leverage new network designs in product development and sales educational resource to develop sales training and materials for sales staff to use in selling the value of new network designs.
6. Provides insight, overview and direction on our financial submissions to BHI, Milliman and the Consortium to ensure market competitiveness.
7. Capitalizes on data requirements to ensure all aspects of the data are being optimized for discount analysis.
8. Acts as the key focal point for all questions, submission and analytics related to discount analysis reporting and submissions.
9. Manages the department including interviewing and hiring employees following required EEO and Affirmative action guidelines and ensuring employees receive proper training. Conducts performance evaluations, and is responsible for managing employees, including skill and career development, policy administration, coaching on performance management and behavior, employee relations and cost control.
The job description in not intended to be an exhaustive list of all functions and responsibilities of the position. Employees are held accountable for all functions of the job. Job duties and the % of time identified for any function are subject to change at any time.
- Work is performed in an office setting
- In-state and out-of-state travel occasionally required
- Required travel between Eagan campus building locations
Qualifications
Required Qualifications:
- Accepting this director level position at BCBSMN requires signing an Agreement Regarding Non-Disclosure of Confidential Information and Non-Competition as a condition of employment.
- Bachelor’s degree in business, healthcare administration or related field and at least 7 years’ experience in Network Management for a health plan
- Strategic vision combined with operational excellence, thinks strategically and implements tactically to consistently deliver results
- Leadership skills that demonstrate the ability to lead people and get results through others
- Excellent business execution skills to drive for results
- Ability to work independently and to make sound business decisions.
- Strong business and financial acumen
- Demonstrated ability to use data to drive results on a large scale.
- Advanced interpersonal skills and the ability to build relationships with and to influence a wide variety of internal and external stakeholders.
- Highly creative and resourceful with the ability to effectively identify, collect, analyze and interpret data to create a market leading discount position
Blue Cross Blue Shield of Minnesota 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, or any other legally protected characteristic.
Primary Location: United States-Minnesota-Eagan
Shift: Day Job