Job Description

Job Description Summary:

The role develops strategies and solutions to address emerging product service requirements for national healthcare delivery for BCBSA programs. Provide product owner leadership to and interface between areas of BCBSA, Blue Plans and their customers, vendors and other business partners. Support the analysis and design of business models which address national market requirements, including operational processes, organization, human performance and financial impacts. Lead product integration activities and product owner activities for large, complex, national scale project implementations.

In support of BluesNet and Network Business Services, this specific role provides business analysis and operational coordination for fee-for-service network offerings, including service governance, onboarding and offboarding, vendor and contract support, billing and financial activities, stakeholder engagement, and process improvement. The role also partners with network engineering leadership to help translate business needs into network architecture and strategic engineering design requirements."

Job Description:

Conducts research and analysis to determine feasibility of emerging business opportunities, including impact to business models for business functions (Program Operations, Product Development, Marketing, Finance, E-Business, Performance, etc.) supporting National Account business, Blue Plans and their customers. Conducts requirements gathering and analysis to support business needs, and develops strategy, policy and operational recommendations. Develops business case and vision based on input from sr. management, Plan executives, user groups, workgroups or governance representatives. Develops communication materials to obtain the necessary direction on recommended solutions from sr. management, governance and other internal and external forums.

Leads implementations of enhancements and facilitates integration between the various BCBSA areas, data and inputs. Directs individuals, teams and workgroups, drives decisions and ensures that customers have the required business and technical solutions and supporting documentation to be successful.

Provides support to Product Manager and consultants on the development of business use cases and high-level business focused non-functional requirements. Works with business and technical teams to assure effective development, testing and implementation of inter-Plan capabilities necessary for BCBSA systems.

Develops support and training materials for Plans and internal staff supporting project implementations. Conducts training for Plan and internal staff on project offering, scope, status and related technology. Coaches and mentors team members.

Serves as a consultant to Plans to assist them in implementing changes and other national scale programs, maximizing efficiencies and improving provider, member and partner Plan satisfaction. Keeps current on divisional, Association and industry trends and technical offerings/requirements to assure compliance.

The posting range for this position is:

107,700.00 - 156,150.00

Qualifications:

Education

• Required Bachelor's Degree in business, management, computer science, information systems, related field or equivalent work experience
• Preferred Master's Degree

Experience

• Required 5+ Years related business experience
• Experience managing business requirements for large, complex projects in healthcare industry.
• Experience working with Blue Plans
• Experience working in a healthcare setting, e.g. healthcare association, healthcare delivery site
• Experience supporting network services, telecommunications, managed services, or other technology-enabled service operations.
• Experience with vendor and contract coordination, billing or financial operations, customer onboarding and offboarding, and operational process improvement.

Knowledge Skills and Abilities

• Excellent Business Analyst skills; ability to lead and perform requirements elicitation in support of enhancements to emerging and existing BCBSA business.
• Technical proficiency with Microsoft Office.
• Working knowledge and understanding of health insurance industry, national health care delivery and/or Plan operations.
• Effective interpersonal and communication (both verbal and written) skills, including ability to develop and communicate materials for sr. management audience.
• Project management/lead skills; ability to apply prior knowledge and skills to lead brand new projects never done before as well as projects done in a new way; ability to complete projects on time, prioritize multiple tasks, prepare work plans and proactively seek out guidance on related project issues; ability to lead system-wide teams to achieve project and/or business goals, and build consensus for business results in a decentralized decision-making structure.
• Relationship management skills; partner with other business stakeholders to incorporate perspectives from other functional areas and consider alternative perspectives and approaches; work with key internal and external stakeholders including BCBSA leadership to create and meet objectives; manage competing needs of multiple stakeholders, including the ability to effectively execute priorities.
• Analytical skills; abilities that include the ability to acquire and organize data, deliver analysis and identify major findings.
• Preferred: Demonstrates AI literacy and an understanding of generative AI tools, including appropriate business applications and limitations.
• Knowledge of service governance, vendor performance management, contractual obligations, service-level agreements, and issue escalation practices.
• Ability to support billing and financial operations, including validating transactions, tracking forecasts and financial variances, resolving discrepancies, and preparing business reporting.
• Ability to coordinate complex customer onboarding and offboarding activities across technical, Information Security, Legal, Brand, Finance, and vendor stakeholders while maintaining accurate documentation and status reporting.
• Ability to translate business and stakeholder needs into clear requirements for network services, architecture, and engineering teams.
• Proficiency with collaboration, workflow, and reporting tools used to manage requests, documentation, project tracking, and process improvement.

#LI_HYBRID

The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.