Manager Government Programs Partner Relations (Job Number:10309)
Description
Summary:
This position will oversee county and non-traditional provider relations that support government programs Medicare and Medicaid products. The position will Monitor and evaluate the product line performance including market share, profitability, growth, customer feedback and competitive insights. They will lead the development of and provision of semi-annual Care Coordination delegate training, conducting annual care plan audits and ensuring post-audit follow up, serving as a regulatory and Blue Plus subject matter expert/resource and providing delegate oversight. The Manager is an internal and external subject matter expert as well as a coach and support to their employees.
Accoountabilities:
1. Maintain technical and regulatory Government Programs Medicaid and Medicare product expertise and serve as product resource and expert to internal and external partners. Provide day to day product management oversight for operations and budget.
2. Monitor and evaluate the product line performance including market share, profitability, growth, customer feedback and competitive insights. Advance strategies that support the overall segment plan and corporate initiatives: health care value, consumer focus, market position and operating excellence.
3. Drive employee performance management objectives, providing feedback and development support to reporting staff.
4. Develop and maintain strong cross-functional business relationships with internal and external partners in order to effectively manage product lines, drive product-related process improvement and provide leadership of collaborative teams that cross departments and BCBSM business units, such as Network Management and Integrated Health Management, and community provider partners. Staff internal and external workgroups.
5. Implement and maintain a comprehensive delegate oversight program to ensure that contracted entities adhere to contract and compliance requirements and, in consultation with Manager, impose corrective and/or disciplinary action plans when required. Foster effective delegate relationships through facilitation, coaching, mentoring, and teaching.
6. Direct the development of training curriculum and provision of semi-annual delegate training both face to face and through webinar technology.
7. Lead the planning and execution of annual care plan audits, including assisting in the development of the audit protocol and process design and required post audit follow up.
8. Lead the development of delegate guidelines, forms, resources, and process improvement initiatives.
9. Manage product related promotional activities such as conference booths, ad hoc trainings, and child and teen check-up/lead screening outreach activities.
Qualifications
Required Qualifications:
- Bachelor's degree and 5 years relevant experience in health care, social services, or related field
- 3 years of working knowledge of current managed health care field and key competition.
- 3 years experience managing projects involving multiple team members and including task assignment, working with key customers (internal or external), managing team and customer relationships and managing project deliverables.
- Exceptional and demonstrated ability to build strong working relationships with vendor partners and internal and external business partners.
- Demonstrated ability to work independently and handle a variety of responsibilities.
- Exceptional and demonstrated organizational and time management skills with ability to shift priorities as business demands require.
- Excellent and demonstrated facilitation and presentation skills.
- Exceptional and demonstrated conceptual and analytical skills.
- Exceptional and demonstrated ability to think and plan strategically; strong attention to detail.
- Must be self-motivated with strong initiative to learn.
- Exceptional and demonstrated effective verbal and written communication skills.
- Demonstrated process and quality improvement experience.
- Ability to travel.
Preferred Qualifications:
- Registered Nurse, Public Health Nurse, or licensed Social Worker with current MN license.
- Mentoring, coaching experience
- Health related auditing experience
Physical description:
Is a sedentary position; requires extensive use of computer and telephone.
The job description is not intended to be an exhaustive list of all functions and responsibilities of the position. Employees are held accountable for all of the functions of the job. Job duties and the % of time identified for any function are subject to change at any time.
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 position will oversee county and non-traditional provider relations that support government programs Medicare and Medicaid products. The position will Monitor and evaluate the product line performance including market share, profitability, growth, customer feedback and competitive insights. They will lead the development of and provision of semi-annual Care Coordination delegate training, conducting annual care plan audits and ensuring post-audit follow up, serving as a regulatory and Blue Plus subject matter expert/resource and providing delegate oversight. The Manager is an internal and external subject matter expert as well as a coach and support to their employees.
Accoountabilities:
1. Maintain technical and regulatory Government Programs Medicaid and Medicare product expertise and serve as product resource and expert to internal and external partners. Provide day to day product management oversight for operations and budget.
2. Monitor and evaluate the product line performance including market share, profitability, growth, customer feedback and competitive insights. Advance strategies that support the overall segment plan and corporate initiatives: health care value, consumer focus, market position and operating excellence.
3. Drive employee performance management objectives, providing feedback and development support to reporting staff.
4. Develop and maintain strong cross-functional business relationships with internal and external partners in order to effectively manage product lines, drive product-related process improvement and provide leadership of collaborative teams that cross departments and BCBSM business units, such as Network Management and Integrated Health Management, and community provider partners. Staff internal and external workgroups.
5. Implement and maintain a comprehensive delegate oversight program to ensure that contracted entities adhere to contract and compliance requirements and, in consultation with Manager, impose corrective and/or disciplinary action plans when required. Foster effective delegate relationships through facilitation, coaching, mentoring, and teaching.
6. Direct the development of training curriculum and provision of semi-annual delegate training both face to face and through webinar technology.
7. Lead the planning and execution of annual care plan audits, including assisting in the development of the audit protocol and process design and required post audit follow up.
8. Lead the development of delegate guidelines, forms, resources, and process improvement initiatives.
9. Manage product related promotional activities such as conference booths, ad hoc trainings, and child and teen check-up/lead screening outreach activities.
Qualifications
Required Qualifications:
- Bachelor's degree and 5 years relevant experience in health care, social services, or related field
- 3 years of working knowledge of current managed health care field and key competition.
- 3 years experience managing projects involving multiple team members and including task assignment, working with key customers (internal or external), managing team and customer relationships and managing project deliverables.
- Exceptional and demonstrated ability to build strong working relationships with vendor partners and internal and external business partners.
- Demonstrated ability to work independently and handle a variety of responsibilities.
- Exceptional and demonstrated organizational and time management skills with ability to shift priorities as business demands require.
- Excellent and demonstrated facilitation and presentation skills.
- Exceptional and demonstrated conceptual and analytical skills.
- Exceptional and demonstrated ability to think and plan strategically; strong attention to detail.
- Must be self-motivated with strong initiative to learn.
- Exceptional and demonstrated effective verbal and written communication skills.
- Demonstrated process and quality improvement experience.
- Ability to travel.
Preferred Qualifications:
- Registered Nurse, Public Health Nurse, or licensed Social Worker with current MN license.
- Mentoring, coaching experience
- Health related auditing experience
Physical description:
Is a sedentary position; requires extensive use of computer and telephone.
The job description is not intended to be an exhaustive list of all functions and responsibilities of the position. Employees are held accountable for all of the functions of the job. Job duties and the % of time identified for any function are subject to change at any time.
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