Director, Strategic Planning and Performance

Blue Shield of California•Long Beach, CA

About The Position

Your Role The Health Plan Operations (HPO) team provides operational support to Blue Shield of California. The Director, Health Plan Operations Optimization leader will report to the Senior Vice President, Health Plan Operations. In this role you will support several programs including governing the HPO Business Optimization program and portfolios for HPO team in Customer Experience, Claims, Healthcare Business Operations and end to end Backoffice operations.. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Responsibilities Your Work In this role, you will:

Requirements

Requires a bachelor's degree or equivalent experience
Requires at least 10 years prior relevant experience, including 6 years of management experience
Requires in-depth experience in Health Plan or Health Care Operations (Claims Operations, Customer Experience, etc.)
Requires experience leading operational teams in a matrixed organization
Requires exceptional verbal and written communication skills, including an ability to communicate effectively at the executive level
Requires ability to influence peers and senior executives across functional teams

Nice To Haves

12 years of prior relevant experience preferred

Responsibilities

Provide strategic and tactical planning as well as oversight and program implementation for Health Plan operations teams in Customer Experience, Claims, Healthcare Business Operations (AGD, Billing, provider dispute resolution).
Provide direction and management for process improvements for end to end operations, includes complexity de-scoping documentation and governance for all Health Plan Operations improvements
Maintain tracking and analysis for critical improvements with Return On Investment (ROI), Key Performance Indicators (KPIs) delivery while managing risk for audits both internally and externally
Provide thought leadership to the Health Plan Operations organization and other cross-functional leaders throughout BSC and Stellarus
Develop business and operations improvement strategies for Health Plan Operations
Oversee service, technology and financial performance metrics for Health Plan Operations teams
Define and support the implementation of organizational and operational structures, systems and processes to facilitate business performance including operations improvement and regulatory requirements; and ensure optimization of resources by resolving any duplicative improvement efforts and organization structures
Provide executive oversight and leadership to managers responsible for creating and driving implementation of operating plans, which are required to support immediate and long-term requirements and business strategies
Ensure customer-driven Key Performance Indicators (KPIs) and goals are in place, which are reflective of and measure our strategic, competitive and regulatory position with ongoing measurement, reporting, and root cause analysis
Identify end-to-end process improvements throughout the organization designed to create efficiencies and allow us to scale for growth and/or operational requirements, such as increasing automation and adoption of self-service.