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The hiring range for this role is: &nbsp;107,666.00 - 150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary: Lead and coordinate the design of the national healthcare data warehouse initiative. This role will be responsible for management and coordination of internal and external resources to successfully deploy multiple complex aspects of the overall initiative. Work with multiple stakeholders to identify and evaluate potential opportunities for future enhancements.Responsibilities include but are not limited to:<ul><li>Lead and manage vendor project team to ensure successful design of data warehouse initiative to meet Plan needs and follow best practices. Develop effective means to coordinate and replicate multiple project deployment activities.</li><li>Provide healthcare subject matter expertise in the direction and audit of project team deliverables.</li><li>Lead technical design to ensure business intelligence best practices are employed. Ensure proper dissemination and communication of business and technical specifications to all constituents.</li><li>Interact, coordinate and effectively manage Plan relationships to ensure successful deployment of varying aspects of data warehouse initiative. Ensure implementation meets BHI policy, data quality standards and processes that govern national data warehouse integrity Conduct post deployment review with each new Plan.</li></ul>Required Education, Certifications and Experience:Education:<ul><li>Bachelor’s degree related to position (i.e. Healthcare, Math, Statistics) or equivalent experience</li></ul> Experience:<ul><li>5 years experience either working for or consulting with healthcare insurance industry</li><li>Experience in the coordination, integration and deployment of data warehousing and business intelligence projects in healthcare industry</li><li>Experienced in vendor management</li><li>Experience with fundamental financial, performance, and quality measures used in healthcare payer industry </li></ul>Skills<ul><li>Demonstrated experience delivering data warehouse and business intelligence solutions in healthcare industry</li><li>Strong critical thinking capabilities, as well as effective oral and written communication skills</li><li>Strong problem solving skills, interpersonal skills,</li><li>Understand issues related to data collection and analysis in healthcare payer industry</li><li>Understand data processing techniques involved in integrating data into a data warehouse</li><li>Strong planning, coordination, analytical and communication skills</li><li>Skilled in performing competitive research and market analysis</li><li>Ability to provide guidance to Plans in understanding business value of the initiative</li><li>Ability to develop storyboard and deliver business presentations</li><li>SQL Query skills highly preferred</li></ul> #LI_REMOTE

Blue Cross Blue Shield Association

Project Leader Deployment

The hiring range for this role is: &nbsp;92,086.00 - 129,145.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.This role evaluates compliance with regulations and develops corrective action plans. Deliver training to BCBSA and Plans, handling complex issues. Act as a resource and consultant on audit activities, developing programs, policies, and procedures to prevent abuse. Leads and support projects, provides guidance on budget, costs, service charges, and incentives.Primary Job Functions<ul><li>Evaluates the level of compliance with applicable federal regulations, contractual requirements and procedures at BCBSA and Plans. Maintain the BCBSA compliance plan as part of these activities and serves as the main point of contact for BCBSA and Plans financial and claims audits.</li><li>Serves as subject matter expert for BCBSA financial policies and procedures BCBSA and Plans regarding the audit process; instructs audit flow facilitation; analyzes and assesses audit trends, best practices and risk; and develops an overall and effective audit program.</li><li>Assists leaders with other assignments on an ad hoc basis.</li><li>Develops and presents training to BCBSA and Plans as it relates to all types of audits.</li></ul>Education, Experience, and CertificatioEducationRequired: Bachelor’s degree in accounting, business, finance or related field, or equivalent experience Experience Required:Minimum of 4 years of related work experience, including progressively more complex assignments; proficiency with Microsoft Office or similar software (Excel, Word, PowerPoint, Outlook).Preferred: Experience in health care or government contracting environment; Blues Plan experience CertificationsPreferred Certification: Financial Services\Certified Public Accountant (CPA)Preferred Certification: Healthcare / Insurance\ACMA - ACM - Certified Case Management Preferred Certification: Legal, Risk, Contracts &amp; Governance\IIA - Certified Internal Auditor (CIA ​ Knowledge, Skills, and Experience<ul><li>Intermediate knowledge of auditing, finance and claims operations</li><li>Demonstrate advanced negotiation, analytical, and problem solving skills, as well as strong project management, interpersonal, and organizational skills</li><li>Ability to take complex audit issues and seek resolution</li><li>Demonstrate ability to develop and maintain business relationships, as well as the ability to create strategies that support initiatives and translate these into action plans</li><li>Ability to direct customers and related parties through influence rather than authority; excellent written, oral and presentation skills.</li></ul> Financial Responsibilities Revenue Management: NoBudget Management: NoPeople Management: No#LI-Hybrid

Sr. FEP Financial Auditor

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.This role provides medical policy expertise across multiple responsibilities including management of staff of Senior Research Scientists in the evidence review and synthesis process. Participates in cross-collaborative projects, and Blue Plan Medical Policy Group (MPG) engagements regarding development and updating of reference medical policies and topic selection. Builds and maintains effective relationships with BCBS Plan Medical Policy Medical Directors that serve on the MPG. Fosters productive cross-collaboration within Blue Cross Blue Shield Association, the Clinical Informatics Team, and other internal divisions.Primary Job Functions<ul><li>Cultivates and maintains strong relationships with BCBS Plan Medical Policy Director who serve on the MPG. Collaborates effectively with key stakeholders within Office of Clinical Affairs, the Clinical support Team, the Clinical Solutions Team and other BCBSA divisions.</li><li>Fosters successful cross-collaboration efforts across departments, ensuring seamless communication and alignment of medical policy initiatives.</li><li>Leads the development and refinement of medical policies, ensuring alignment with industry standards, evidence-based practices, and regulatory requirements and working knowledge of procedural and diagnostic coding.</li><li>Oversees the day-to-day operations related to medical policy solutions. Manages Senior Research Scientists, coordinating research efforts, and ensuring timely policy updates.</li><li>Manages the budget allocated for medical policy initiatives, optimizing resources and ensuring cost-effective solutions.</li></ul>Education, Experience and CertificationEducation Required: Masters DegreePreferred:Clinical background with health plan and clinical policy development experience preferredLicensed RN or PharmD preferred Experience Required:<ul><li>10 years of progressive healthcare experience developing and aligning operational goals and objectives. This experience should also include conducting research, evaluating evidence review documents, and implementation of strategies to influence organizational behavior or organizational culture.</li><li>Management experience including managing staff, budget, and leading performance improvements efforts.</li></ul>Preferred:<ul><li>Experience working with academic medical centers, clinical research payers, industry, regulatory agencies, and/or accreditation organizations.</li><li>Experience working with physician specialty organizations.</li></ul>Knowledge, Skills, and Abilities Skills<ul><li>Strong scientific background and acumen with experience in technology evidence review and synthesis.</li><li>Requires excellent oral and written communications skills with the capabilities to negotiate, influence, and make effective presentations to varying audiences internal and external to BCBSA.</li><li>Ability to provide expertise as a thought leader and demonstrate credibility amongst clinical and business leaders across BCBS system.</li><li>Working knowledge of coding and the role of coding in medical policy.</li><li>Professional presence for interacting with and influencing key members of leadership.</li><li>Excellent interpersonal skills for building and fostering key stakeholder relationships. Must be able to represent BCBSA in various forums and with various audiences.</li><li>The ability to establish credibility and achieve results while balancing various business considerations and priorities is critical.</li><li>The ability to demonstrate prudent judgment and critical thinking relative to problem analysis at both strategic and tactical levels.</li></ul>Financial Responsibilities Revenue Responsibility: NoBudget Responsibility: YesPeople Management: Yes#LI-Hybrid

Director Medical Policy Solutions

The hiring range for this role is: &nbsp;$107,666.00 - $160,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary As a Senior Security Engineer, you will collaborate with Architects and key stakeholders to interpret and implement engineering and operational guidance within a specific security domain or program. You will contribute to multiple projects, leading the creation of comprehensive roadmaps for various projects or departments. Your role will involve championing operational excellence by designing and executing advanced process improvement initiatives. You will drive significant cost optimization efforts by identifying and implementing strategic savings opportunities. Additionally, you will enhance security risk visibility by developing and overseeing robust risk management frameworks. You will also participate in domain-related incident response efforts as needed, maintain defined security architecture, and manage domain-specific security tools.Responsibilities include but are not limited to:<ul><li>Works with Architects and key stakeholders to interpret engineering and operational guidance in a specific security domain/program and contributes to multiple projects related to it.</li><li>Lead the creation of comprehensive roadmaps for multiple projects or departments.</li><li>Champion operational excellence by designing and executing process improvement initiatives.</li><li>Drive significant cost optimization efforts by identifying and implementing strategic savings opportunities.</li><li>Enhance security risk visibility by developing and overseeing robust risk management frameworks.</li><li>Participate in domain related incident response efforts as needed, maintain defined security architecture, and manage domain specific security tools.</li></ul>Required Education, Certifications and ExperienceEducation Required: Bachelor's degree in Computer Science, Information Security, or related field or equivalent work experience. ExperienceRequired: 7+ years of cyber security experienceGeneral:<ul><li>Experience implementing risk remediation prioritization and collaboration with key stakeholders to understand risk drivers and remediation blockers.</li><li>Experience monitoring and tracking remediation efforts, staying abreast of emerging threats, and leading the design, implementation, and maintenance of domain specific toolsets.</li></ul>IAM (Identity and Access Management) Domain Role:<ul><li>Relevant engineering experience, preferably in hybrid cloud environments leveraging DevOps and other automation models to drive IAM program maturity.</li><li>Experience in designing and deploying identity-focused workflows, and functions in enterprise environments.</li><li>Experience with Active Directory, LDAP (Light-weight Directory Access Protocol), IGA (Identity Governance and Administration), PAM (Privileged Access Management), EIAM (Enterprise Identity Access Managment), SSO (Single Sign-On, MFA (Multi-factor Authentication), federation/SAML (Security Assertion Markup Language) or equivalent.</li><li>Experience with SailPoint Identity Security Cloud IAM automation and other software automation and orchestration tools including provisioning, configuration management, application-deployment, network segmentation and monitoring, server monitoring and visualization.</li></ul> Certifications Preferred: CISSPKnowledge, Skills, and Abilities<ul><li>Ability to plan, develop, implement, and update company’s information security strategy.</li><li>Excellent communication skills</li><li>Excellent presentation skills that cater to technical and non-technical audiences.</li><li>Strong analytical and problem-solving skills and ability to manage multiple projects successfully, ensuring timely and budget-friendly completion.</li><li>Strong interpersonal skills, and the ability to influence and solve problems effectively.</li><li>Solid understanding of HIPAA/HITRUST requirements, cloud-first security practices, and various security tools and technologies.</li></ul> Financial Responsibilities Revenue Responsibility: NoBudget Responsibility: No People Management: No

Senior Security Engineer - IAM

The hiring range for this role is: &nbsp;$107,666.00 - $160,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary As a Senior Security Engineer, you will collaborate with Architects and key stakeholders to interpret and implement engineering and operational guidance within a specific security domain or program. You will contribute to multiple projects, leading the creation of comprehensive roadmaps for various projects or departments. Your role will involve championing operational excellence by designing and executing advanced process improvement initiatives. You will drive significant cost optimization efforts by identifying and implementing strategic savings opportunities. Additionally, you will enhance security risk visibility by developing and overseeing robust risk management frameworks. You will also participate in domain-related incident response efforts as needed, maintain defined security architecture, and manage domain-specific security tools.Responsibilities include but are not limited to:<ul><li>Works with Architects and key stakeholders to interpret engineering and operational guidance in a specific security domain/program and contributes to multiple projects related to it.</li><li>Lead the creation of comprehensive roadmaps for multiple projects or departments.</li><li>Champion operational excellence by designing and executing process improvement initiatives.</li><li>Drive significant cost optimization efforts by identifying and implementing strategic savings opportunities.</li><li>Enhance security risk visibility by developing and overseeing robust risk management frameworks.</li><li>Participate in domain related incident response efforts as needed, maintain defined security architecture, and manage domain specific security tools.</li></ul>Required Education, Certifications and ExperienceEducation Required: Bachelor's degree in Computer Science, Information Security, or related field or equivalent work experience. ExperienceRequired: 7+ years of cyber security experienceGeneral:<ul><li>Experience implementing risk remediation prioritization and collaboration with key stakeholders to understand risk drivers and remediation blockers.</li><li>Experience monitoring and tracking remediation efforts, staying abreast of emerging threats, and leading the design, implementation, and maintenance of domain specific toolsets.</li></ul>Data Domain Role:<ul><li>Experience building, testing, implementing, and tuning policies and rulesets across our portfolio of data security tools to accurately detect, classify, track movement of, and protect sensitive data assets from unauthorized access. </li><li>Experience collaborating with security architecture and other stakeholders as part of the Data Governance Committee and Cloud Center of Excellence ensuring that data protection capabilities are designed and implemented securely. </li><li>Experience supporting data and cloud governance teams and other non-security stakeholders to assist with the researching, analyzing, development and implementation, of data security capabilities with a focus on protection, detection, and response.</li><li>Experience supporting security architecture and application teams with developing controls and security monitoring for sensitive access and movement across endpoints, network, SaaS applications, and cloud platforms. </li><li>Experience in Cyber security engineering, preferably in hybrid cloud environments with a focus on data security using automation to discover, assess, classify, tag, encrypt, and mask sensitive data. </li><li>Experience with various data architectures, such as data warehouse, data lakes, data lakehouses, data mesh, data fabrics, and federated data, and management, and governance. </li><li>Experience with tools and services related to IAM, data protection, software provisioning, configuration management, application deployment, network segmentation and monitoring, server monitoring and visualization, and storage, data backup, and collaboration tools. </li><li>Experience Deploying, configuring and supporting AWS (Amazon Web Services) and hybrid cloud environments such as data focused security and privacy tools and services such as Microsoft MPIP/AIP/RMS, AWS Macie, Enterprise and Endpoint DLP, DAM, CASB, HSM, AWS Security Services IAM, KMS, Secrets Manager, AWS Firewall manager, WAF, Guard Duty and SCPs Encryption, masking, tokenization, SSO, secrets management or equivalent. </li><li>Experience in AWS Network Services in AWS (VPC, Route Table, Security Groups, Transit Gateway, Private Link, VPC Interface Endpoint) </li><li>Experience in AWS Management Services (e.g., CloudWatch, Lambda, AWS Config, Security Hub). </li><li>Experience with Infrastructure and Platform Services (e.g., EC2, RDS). </li></ul> Certifications Preferred: CISSPKnowledge, Skills, and Abilities<ul><li>Ability to plan, develop, implement, and update company’s information security strategy.</li><li>Excellent communication skills</li><li>Excellent presentation skills that cater to technical and non-technical audiences.</li><li>Strong analytical and problem-solving skills and ability to manage multiple projects successfully, ensuring timely and budget-friendly completion.</li><li>Strong interpersonal skills, and the ability to influence and solve problems effectively.</li><li>Solid understanding of HIPAA/HITRUST requirements, cloud-first security practices, and various security tools and technologies.</li></ul> Financial Responsibilities Revenue Responsibility: NoBudget Responsibility: No People Management: No

Senior Security Engineer - Data

The hiring range for this role is: &nbsp;$150,000.00 - $200,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs — ones that are injected or infused by a health care professional in a clinical setting — for nearly 100 million Americans. The Senior Director, Rebate Invoicing &amp; Audit is a strategic leadership role responsible for leading the end-to-end invoicing and medical rebate operations team, including oversight of client inquiries, and delivering exceptional value to clients. In addition, this role will partner with Financial Operations and IT leadership on delivery of Synergies’ key initiatives, driving innovation, translating strategic plans into meaningful implementation strategies and project plans while providing insight from a participant perspective. The role will be responsible for driving appropriate oversight for our clients, operating structure, and governance to achieve excellence in business outcomes. In addition, this Senior Director role will be accountable for shaping the long-term vision of client invoicing processes, working collaboratively with senior leaders, cross-functional teams, and key external stakeholders to optimize client experiences, identify interdependencies, and ensure cross-initiative solutions are in alignment.<ul><li>Manage all aspects of the invoicing client relationships and medical rebate operations, including ensuring clients are supported for invoicing issues, working with internal team members, and Invoicers to obtain answers</li></ul><ul><li>Monitor and analyze key performance metrics around client satisfaction and invoicing client operations processes, including providing insights and recommendations on vendor and client trends, risks and opportunities</li></ul><ul><li>Support the in-depth daily work requirements and processes of medical rebates</li></ul><ul><li>Define and execute the daily and long term strategic vision for client invoicing and medical rebate operations, ensuring cross-functional alignment</li></ul><ul><li>Meet consistently with participants and their plans to address questions or concerns on invoicing in a timely manner</li></ul><ul><li>Maintain alignment, lead development and implementation of strategies to enhance interdependencies between all workstreams related to assigned initiative to support client invoicing</li></ul><ul><li>Act as a trusted advisor to the executive leadership team, creating and delivering executive level presentations articulating business objectives, progress, challenges, and successes in stated objectives on client invoicing needs, concerns, and feedback</li></ul><ul><li>Drive transition, rollout, and oversight of change management activities for client impacts</li></ul><ul><li>Identify and manage interdependencies between internal and external strategic initiatives and operational areas to achieve intended value delivery objectives; represent the organization in high-level discussions with external stakeholders, including clients, vendors and invoicing partners to strengthen relationships and optimize client experiences</li></ul><ul><li>Work with VP of Client Relations to lead on any client communications on invoicing and work with Implementation team on client impact and communication for invoicing updates</li></ul><ul><li>Facilitate planning with dependent projects and products including relevant stakeholders and owners to align on program roadmap and goals, budget, and schedule</li></ul><ul><li>Build and mentor a high-performing team, fostering a culture of continuous learning, professional growth, appreciation and innovation</li></ul>Education Bachelor’s degree in Business, Finance, Healthcare Administration, or related area of study, or equivalent combination of education and/or relevant work experience Experience Required:<ul><li>10 years of work experience in client relations, rebates, project management, business data analysis, or other related experience leading company- wide cross-functional work efforts</li><li>Extensive experience in the healthcare or PBM industry, with a deep understanding of client relations, invoicing processes, finance, audit, and regulatory requirements</li><li>Must be eligible to work in the United States without need for work visa or residency sponsorship</li></ul>Preferred:<ul><li>Previous Client Engagement experience preferred</li><li>Previous Program Management experience preferred</li><li>PBM/health care experience preferred</li></ul>Knowledge, Skills, and Abilities<ul><li>Extensive client experience and resolution management experience</li><li>Strong analytical, organizational, and time management skills</li><li>Intermediate to advanced proficiency in data analysis</li><li>Proven ability to counsel, collaborate and influence at the Executive C-suite level and senior leadership</li><li>Proven ability to effectively build, lead and motivate a high performing program team without direct reporting relationships, establishing trusted relationships, promoting candor, and driving results to achieve all program objectives</li><li>Strong communication skills with ability to communicate information in open and sincere manner that promotes credibility</li><li>Excellent collaborator with track record of working with a multitude of different groups, personalities, and levels of people to facilitate resolution of different views</li><li>Ability to work as team player, comfortable with fast paced, changing environment and ambiguity</li></ul>Financial ResponsibilitiesRevenue Responsibility: YesBudget Responsibility: YesPeople Management: Yes#LI-Remote

Sr Director Rebate Invoicing and Audit

The hiring range for this role is: &nbsp;147,190.00 - 206,425.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary: Responsible for developing and leading proactive analyses and strategies for influencing legislation, regulations, and influential third-party stakeholders. Manages identification of key business issues, evaluates impact on Plan business, advances options and forges consensus, and prepares comments and effective advocacy material. Engages with Administration officials and staff to advance BCBSA positions. Works integrally with other senior staff to develop strategies to ensure third parties are aware and appropriately engaged in BCBSA issues, which include stakeholder briefings, and outreach to key influential individuals and organizations on priority BCBSA issues. Identifies opportunities to collaborate cross-divisionally and with key stakeholders to advance BCBSA Board priorities around assigned issue areas. Represents department on internal workgroups and committees, influential third-party groups and coalitions including coordinating feedback on complex health reform proposals – oversees strategies and appropriate staff and consultants to showcase Blue Plan innovations and advance policies on priority issues referenced above as well as emerging topics.Responsibilities include but are not limited to:Independently anticipates and identifies key business and policy issues related to the assigned issue areas listed above. Oversees staff (internal and in other BCBSA divisions) and consultants – through direct supervision and effective coordination – to review legislation and regulations and potential guidance as well as directly reviews legislation, legislative proposals, regulations and Administration guidance and third party proposals to identify and evaluate strategic and business issues for Plans. Works closely with BCBSA senior executives, Plan executives and Plan workgroups, to assure Plan business issues are represented in BCBSA positions. Also works with key internal and external stakeholders to influence and shape legislation, regulation, guidance and third-party proposals Directs or leads coordination with staff and consultants to manage or directly manages projects within assigned regulatory and legislative areas (both federal and state), including the identification of key business issues, policy, and legislative or regulatory analysis, development of comments or other persuasive materials, and development of educational materials for Plans. Represents BCBSA in meetings with Administration officials, policymakers, and other influential policy organizations. Provides policy input and support to State Services on NAIC and other state-related initiatives to assure consistency with regard to state and federal policy positions; and proactively coordinates with lobbying and Communications to ensure cohesive strategy and efficient advocacy of issues. Formulates strategies on an issue-by-issue basis, assuring positions represent consensus of Plans. Communicates and interprets the implications and effects to Plans. Maintains a thorough and comprehensive understanding of Plan business interests/practices to effectively assess the effect of legislation/regulations on them, and to forcefully showcase/promote Plan initiatives on the Hill, with the Administration and before influential third-party stakeholders. Leads discussions on assigned issues on Plan workgroup calls on key issues, coordinating with appropriate BCBSA divisions and consultants. Prepares and implements research agenda for issue areas. Educates lobbying and other Association staff as necessary. Supports Administration outreach efforts by identifying opportunities to leverage BCBSA and Plan initiatives related to health insurance markets, staying up to date on Administration priorities and opportunities for collaboration with HHS. Develops and maintains key contacts, networks of contacts, and effective working relationships with BCBSA and Plan representatives, federal policymakers, interest groups and other external organizations, as necessary, to enhance knowledge of proposed legislation, regulations, and issues, and to ensure the most effective collection and dissemination of information. Plays a leadership role in working with influential third-party stakeholders; also attains leadership positions within other third-party groups focused on relevant issues. Serves as liaison with regulatory representatives from other associations in the health sector. Meets with and develops ongoing relationships with key Administration officials and staff to advance policies.Required Education, Certifications and Experience:Education:<ul><li>Required - Bachelors Degree; Bachelor’s Degree in Political Science, Public Health, Public Administration or related field.</li><li>Preferred - Masters Degree; Master’s Degree in public policy, health policy or related field.·</li><li>Preferred - Membership in American Academy of Actuaries</li></ul> Experience:<ul><li>Minimum 8 years’ experience in health care policy analysis/formulation, health care law, state insurance regulations and/or healthcare plan operations, with experience in public health policy.</li><li>Experience in communicating and writing comments to Congress, government agencies and/or other legislative bodies· Experience with structuring research policy studies and formulating policy alternatives· Experience drawing upon extensive knowledge and relationships to identify and analyze issues and develop appropriate policy strategies and responses, demonstrating excellent judgment and analytical methodologies· Experience in setting and meeting objectives, while reacting within a growing and changing internal and external environment· Experience with a BCBS Plan, other health insurer, state Department of insurance, the Centers for Medicare and Medicaid Services or prior experience with the Department of Labor working on group health plan issues.</li></ul> Skills:<ul><li>Extensive knowledge of managed care and insurance reform issues, operations and policy, as well as knowledge of the federal legislative and regulatory process.</li><li>Extensive knowledge of commercial health insurance markets and ERISA rules affecting group health plans</li><li>Sophisticated/strategic thinking to determine how best to influence decision/policy makers</li><li>Superior facilitation, presentation, organizational and verbal and written skills, with the demonstrated ability to work independently</li><li>Analytical, planning and project management skills, as well as the ability to prioritize and shift multiple issues and projects without compromising quality results</li></ul> People Management:<ul><li>Yes</li></ul>#LI_HYBRID

Managing Director, Legislative and Regulatory Policy - Medicare

The hiring range for this role is: &nbsp;107,666.00 - 150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Responsible for managing various governance-related projects and deliverables within a cross-functional matrix environment. Serves as a central point of contact and as a subject matter expert to provide content development for BCBSA Board committee and subcommittee deliverables. The role also supports the planning and execution of governance operations, including meeting planning, process management, operational support and logistical support. Builds relationships and collaborates with officers, senior management and business owners to address business needs, and support completion of well-written, clear, persuasive, and timely deliverables related to Board-standing Committees and their Subcommittees. Strong, proactive professional with strong writing, project management, organizational skills and attention to detail.Primary Job Functions<ul><li>Accountable for materials development in collaboration with senior leadership and other stakeholders, ensuring timely, accurate, and persuasive deliverables. Works cross-divisionally and in support of senior leadership to ensure consistency and audience-aligned content for governance meetings.</li></ul><ul><li>Key resource supporting corporate objectives through the consistent and successful completion of recurring governance activities for Board-standing committees and their subcommittees. Works cross-divisionally to ensure timeliness, accuracy, and consistency of the materials.</li></ul><ul><li>Manages multiple projects and deadlines effectively and efficiently. Works proactively to identify and resolve issues.</li></ul>Education, Experience and CertificationEducation Required: Bachelors Degree; 4 year college degree. Experience Required: 5 years' related experience in healthcare and corporate governance Knowledge, Skills, and Abilities<ul><li>Knowledge of the health insurance industry, BCBSA and Plans.</li><li>Excellent organizational skills as well as the ability to lead and manage competing projects and priorities.</li><li>Outstanding verbal, written and interpersonal communication skills.</li><li>Demonstrated ability to work effectively at all levels, exercising diplomacy and the ability to work cooperatively and collaboratively with internal business owners and senior leadership, while thriving in a fast-paced, highly visible environment.</li></ul>Financial Responsibilities Revenue Responsibility: NoBudget Responsibility: No People Management: No#LI-HYBRID

Manager of Governance

The hiring range for this role is: &nbsp;107,666.00 - 150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.Job Description Summary: Function as the technical resource across several BCBSA technical projects focusing on the software and infrastructure products developed and supported by Information Technology's engineering and development areas to ensure these solutions meet stakeholder needs. Provides services for Plans and BCBSA staff, including providing tier 2-3 product support in conjunction with Information Technology’s engineering and development teams. Support and interact throughout BCBSA with team members and outside the team with application users (both internal and external), as well as with cross-functional teams and BCBSA external vendors.Responsibilities include but are not limited to:<ul><li>Responsible for the maintenance and administration of application and server resources. In addition, provide analysis, evaluation and support of the environment operation, which includes monitoring systems, resources, applications and users to ensure maximum system availability.</li><li>Provide both order-of-magnitude and detailed estimates for software development activities and artifacts. Develop and refine estimating models based on previous project actuals and trends to improve accuracy of estimates.</li><li>Perform troubleshooting and debugging of Information Technology systems and products to improve performance of products. Partner with business partners and develop teams to identify and implement process to provide technical operations and testing of applications.</li><li>Follow good documentation practices, including producing and managing formal artifacts as well as writing clean, readable and standards-compliant code and unit tests. Serve as serve as primary or backup contact to define non-functional specifications and contribute/ drive to application/system design for supportability, maintainability, and reliability aspects.</li><li>Follow good documentation practices, including producing and managing formal artifacts as well as writing clean, readable, and standards-compliant code and unit tests. Serve as primary or backup contact to define non-functional specifications and contribute/drive to application/system design for supportability, maintainability, and reliability aspects.</li><li>Supervise project teams in a matrix environment. Monitor milestone and project status. Partner with internal and external consultants.</li><li>Managed Service Management</li><li>Architecture, design, capacity planning, technology transformation</li><li>Budget</li><li>Tier 3 Troubleshooting</li></ul>Required Education, Certifications and Experience:Education<ul><li>Required: Bachelor’s Degree in Computer Science, Information Systems, or equivalent work experience in similar work environment.</li></ul> Experience:Required:<ul><li>Minimum 7+ years of IT work experience focused in production support.</li><li>Experience as a team lead or member on project teams in a cross functional environment</li></ul>Certifications:Preferred:<ul><li>Information Systems &amp; Technology\Scaled Agile, Inc - SAFe Agilist Certification (SA)</li><li>Information Systems &amp; Technology\Amazon Web Services (AWS) - Cloud Practitioner</li><li>Information Systems &amp; Technology\Databricks - Certified Data Engineer Associate</li></ul> Knowledge, Skills, and Abilities:<ul><li>Expert knowledge of design, implementation, and management and support of some or all of the following: IBM Mainframe, MQ Series, Vitria Businessware, Sun/Solaris, AIX, Red hat Linux, Oracle, DB2, UDB, SQL, Hadoop, Websphere, PeopleSoft, Cognos BMC Patrol, Control-M, Tivoli. Provide server administration support for Microsoft Windows 2000, 2003, Microsoft Active Directory and Microsoft Exchange 2003, 2007</li><li>Experience as a team lead or member on project teams in a cross functional environment</li><li>Strong analytical skills</li><li>Strong team-oriented interpersonal and communication skills to lead team efforts</li><li>Has thorough understanding of technical concepts required for specialized field. Uses that knowledge, creativity and company practices and priorities to obtain solutions to complex problems</li><li>Excellent written, verbal and listening communications skills</li><li>Ability to communicate effectively with Plan management at all levels of the organization</li><li>Demonstrated experience within a customer focused environment</li><li>Effectively provides work leadership to others.</li></ul>#LI_HYBRID

Production Support Analyst III (AWS Operations)

The hiring range for this role is: &nbsp;107,666.00 - 150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange 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.&nbsp;This job is also eligible for annual bonusincentivepay.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.This role provides guidance and support to internal and/or external business partners on a wide range of issues. Works cross-functionally with teams across the organization to support corporation strategic direction and advance corporate priorities. The role oversees the day-to-day administration and facilitation of BCBSA’s licensure processes. This role ensures compliance with BCBSA license agreements, from application to termination.Primary Job Functions<ul><li>Project Management and Stakeholder Engagement: Leads project teams, ensuring seamless integration of analyses and high-quality deliverables. Oversees analytical work to achieve project goals. Develops project plans from scope to timelines to tasks to resource allocation. Independently manages diverse projects with a solutions-focused approach. Actively engages with stakeholders to understand business needs building and nurturing relationships with internal and external business partners. Serves as point of contact and escalates issues as needed.</li><li>License Management: Under supervision, manages license application processes resulting from affiliations, mergers, start-ups, acquisitions, and joint ventures. Conduct license compliance reviews and identify potential issues promptly, collaborating effectively with BCBSA management and licensees to resolve. Provides practical guidance to management on licensure compliance, operational matters, and corporate issues. Assists in developing proposed amendments to license agreements and related documents. Maintains readiness for license termination contingencies and educates internal and external stakeholders on termination processes. Evaluates complex Plan and BCBSA licensure requests considering alignment to strategy, potential for uncertainty and appropriate brand use.</li><li>Communication, Training, and Presentation: Stays informed about industry initiatives and trends, to continually evolve supportive actions based on industry developments. Leads communications and presentations for internal and external business partners, conducting timely and effective training sessions on licensure requirements for licensees, including on-site training and BCBSA programs.</li></ul>Education, Experience, and Certification EducationRequired: Bachelors Degree Experience Required: Minimum of 5 years of compliance and/or licensing experience; experience working with legal counsel and contracts.Knowledge, Skills, and AbilitiesRequired:<ul><li>Strong written and oral communication skills, including negotiation skills</li><li>Strong organizational and project management skills</li><li>Strong analytical and problem-solving skills</li><li>Ability to prioritize work in fast-paced environment across multiple stakeholder contacts</li><li>Knowledge of standard business software applications such as Microsoft Office, including Word, Excel and PowerPoint</li><li>Skilled working independently and as part of a team</li><li>Effective interpersonal skills to promote value-added services and maintain positive relations with stakeholders at all levels</li></ul>Preferred:: Knowledge of healthcare insurance industry.Financial Responsibilities Revenue Responsibility: No Budget Responsibility: No People Management: No#LI-Hybrid

16 Blue Cross Blue Shield Association Jobs