Job Information
Blue Cross and Blue Shield of Louisiana eleHealth Business Process Manager in Monroe, Louisiana
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE .
The eleHealth Business Process Manager is responsible for creating an integrated process-and-technology plan that supports and advances business performance by collaborating with leadership to understand and clarify the organization’s strategy, goals, business objectives and challenges. Leading a small, nimble, process-and-technology-solution design team, consults to creates plans to evolve business and technical capabilities to adapt to new challenges and capitalize on identified opportunities.
How You Contribute to the Company’s Mission In This Role
Responsible for working on services to envision, facilitate and lead the design of the model with a multi-disciplinary team, and build an implementation plan, document the service design and operating procedures. This includes partnerships where we are buying/leasing a service.
Is responsible for the planning of Louisiana Blue services portfolio and ensuring the right stakeholders from our MSO providers, Louisiana Blue, and venders partners and involved in strategic planning.
Leads the organization’s efforts to identify and pursue opportunities for technology selection/adoption and process standardization and improvement. Leads the creation of tactical tools in support of improved insight and performance and track plan productivity and achievement of performance metrics.
Develops and implements technology and process optimization roadmap to support the core functions of the eleHealth group of entities, which are start-ups which includes business planning, budgeting, service development, market research and growing the MSO
Coordinates the CMS MSSP application process and manages the contract including all contraction negotiations and data submission in collaboration with the Director of Clinical Operations.
Supports the company ACO entities to properly record value-based contracts.
Negotiates and manages all value-based contracts held by the ACO on behalf of ACO Medical Group and MSO practices in collaboration with the SVP.
Ensure that process and technology solutions adhere to a framework or architecture that is secure, scalable, affordable, and nimble.
Keep abreast of changes in both the business and technology landscapes.
Required Qualifications
Bachelor’s degree in Business, Finance, Marketing, Accounting, Statistics, Health Care Administration, Project Management, Industrial Engineering, Information Systems or related field
7 years of experience to include business architecture, business application, business process, and business information flow practice in a health care environment. Provider experience required.
Experience as the leader or principal contributor to a multi-faceted configuration and install of a new technology system affecting multiple core work processes and experience with large scale technology venders and platforms including Healthcare electronic medical records. Preferably EPIC.
Experience developing target state business processes and technical plans and roadmaps
Skills in value-based care and shared savings models, innovative thinking, finance, performance improvement, complex problem-solving, account/relationship management, strong communication and organizational skills, influence skills and project management skills.
Knowledge of value-based reimbursement models, provider transformation, performance improvement planning, healthcare data and root cause analysis, knowledge of payors and providers operations and key levers for driving improved cost, utilization and patient experience are required.
High proficiency in Microsoft Office software (Excel, Word, PowerPoint and Outlook)
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
JOB CATEGORY: IT, Telecom & Internet