Director, Ancillary and TPA Solutions

Blue Cross Blue Shield of Michigan • Detroit, MI

3d

About The Position

The Director, Ancillary and TPA Solutions is accountable for the strategic development and oversight of ancillary solutions for Commercial Markets and Government Programs, where applicable. This role is also accountable for the ongoing oversight of all Shared Administration capabilities, operational effectiveness and compliance and development and implementation of new TPA related solutions. This role is accountable for assessing the market solutions for ancillary, complementary and TPA solutions and negotiating favorable contracts on behalf of BCBSM and holding engaged vendors accountable for achieving contract requirements. Oversee contract and vendor management activities for ancillary and complementary solution vendors, including assessment of market options, negotiation of contract terms, establishment of performance expectations, and enforcement of contractual requirements across Commercial Markets and applicable Government Programs. Provide enterprise oversight of third-party administrator solutions, including Blue Water TPA and shared administration capabilities, ensuring administrative performance, operational effectiveness, regulatory compliance, and alignment to enterprise standards. Lead a high performing vendor management center of excellence that deploys and governs enterprise standards for vendor management, including but not limited to policy, framework, standards, vendor governance, training and technology. Drive enterprise relationship management for strategic vendors delivering services across multiple functional areas, coordinating vendor performance management, governance activities, and issue resolution in partnership with business and functional stakeholders. Manage the incident management process to adequately resolve and mitigate vendor incidences that have an impact on operations, while recommending improvements to prevent recurrence. Oversee enterprise third party risk management and financial due diligence for in scope vendors across the vendor lifecycle, including evaluation, contracting, onboarding, monitoring, and off boarding, in partnership with risk, compliance, legal, finance, and procurement teams. Prepare and present formal presentations, including the performance of the vendor portfolio and business cases to executive leadership.

Requirements

• Bachelor’s degree in related field required.
• Minimum 10 years’ experience leading supplier or vendor management functions within complex, matrixed organizations.
• Minimum 10 years’ experience overseeing large scale outsourced relationships, including shared services, TPA operations, and third-party risk management.
• Demonstrated ability to develop and manage supplier engagement and governance strategies at an enterprise level.
• Strong analytical capability to evaluate operational and financial performance, costs, and market trends to support data driven decision making.
• Proven effectiveness in cross functional collaboration and influencing without authority across business, legal, finance, procurement, risk, and compliance stakeholders.
• Executive level communication and stakeholder engagement skills.

Responsibilities

• Strategic development and oversight of ancillary solutions for Commercial Markets and Government Programs.
• Ongoing oversight of all Shared Administration capabilities, operational effectiveness and compliance.
• Development and implementation of new TPA related solutions.
• Assessing market solutions for ancillary, complementary and TPA solutions and negotiating favorable contracts.
• Holding engaged vendors accountable for achieving contract requirements.
• Overseeing contract and vendor management activities for ancillary and complementary solution vendors.
• Providing enterprise oversight of third-party administrator solutions, including Blue Water TPA and shared administration capabilities.
• Leading a high performing vendor management center of excellence.
• Driving enterprise relationship management for strategic vendors.
• Managing the incident management process for vendor incidences.
• Overseeing enterprise third party risk management and financial due diligence for in scope vendors.
• Preparing and presenting formal presentations to executive leadership.

What This Job Offers

• Job Type: Full-time
• Career Level: Director