Posted: Thursday, January 4, 2018 1:45 AM
About Blue Cross
Founded in 1933, Blue Cross and Blue Shield of Minnesota is the largest health plan in the state. We have more members, the largest network of providers and more products and services than any other plan in Minnesota. From the beginning, Blue Cross has been an innovator with a mission of making a healthy difference in people's lives.
We understand the importance of finding a job that you truly enjoy - at a company that shares your values. We've made it easy to feel good about working at Blue Cross by encouraging volunteerism, valuing diversity and offering the flexibility you need to live a balanced life. We offer a suite of comprehensive medical and dental benefits as well as competitive pay, flexible work schedules and generous personal paid time off in addition to 20 hours of volunteer paid time off each year. We look forward to serving Minnesotans over the next 80 years and beyond. Join us and make a healthy difference through the work you do every day.
Description Summary 13;
This position is accountable for driving continuous improvement efforts related to Medicare and QRS Star Ratings, including Part C and Part D administrative measures both within Blue Cross and in pharmacy benefit management vendors. The position will partner with leaders across the organization to establish, measure, implement and evaluate process improvement initiatives that align with the organizations established goals. The position directs medium to large continuous process improvement engagements, performs research, strategically analyzes findings and drives the implementation of process changes.
:Drives process improvement across the enterprise and with vendors to achieve Star goals in all administrative aspects Medicare Star program in Part C and Part D.
:Direct project plans which support meaningful, relevant, and sustainable change that support long:term success in the Medicare and QRS Star programs and drive improved member satisfaction through application of project management, data analysis, meeting management and group facilitation skills to deliver high quality solutions with high levels of customer satisfaction
:Leverage organizational knowledge and business acumen to develop effective project teams, leading through influence to successfully complete continuous improvement projects
:Partner with corporate and PBM appeals, quality and health management, compliance, member and provider contact centers, and other Enterprise partners to design, promote and drive development of administratively related Star initiatives.Analyze rating elements, identify opportunities for program improvements, and design and manage initiatives to support these improvements.
:Identify technical requirements for both reporting and data sharing across vendors and regulators, and identify either current resources and/or gaps in data systems. Analyze data as needed to meet strategic goals.Research and maintain technical expertise of data file specifications.
:Lead cross:functional program oversight teams and provide consultation as a subject matter expert as needed to all internal stakeholders.
:May develop and manage vendor contract(s); manages project budget(s).
:May participate in the coaching, mentoring, and training of other employees.
:Perform other accountabilities as assigned.
:Bachelors degree in business, nursing, public health, health science, health promotion or related field or equivalent education and experience.
:7 years related experience; i.e. experience working on or leading projects in a health care setting or in a setting requiring these same skills and ability, and including experience with clinically oriented or population health projects or 9 years of related work experience in lieu of a degree.
:Demonstrated knowledge of regulatory Medicare requirements, technical specifications for Me
• Location: Minneapolis / St. paul
• Post ID: 28623687 minneapolis