FEP Operations Program Specialist

Blue Cross Blue Shield Association•Washington, DC

2d•$73,655 - $97,263•Hybrid

About The Position

This position supports the vendor relationship, daily operations, and delivery of member benefits. This position collects, maintains, and resolves issues, shares program operational and performance data, supports timely resolution of inquiries, communication development, process documentation, reporting, implementation, compliance, and audit activities in support of and in compliance with the applicable policies and regulations. Account and Operations support ensures timely resolution of member inquiries from various sources. It identifies and communicates performance and compliance risks to leadership, reviews regular reports to address issues, and manages communication requests and system updates in compliance with applicable standards. Additionally, it supports and interacts with stakeholders to resolve inquiries and fosters collaborative relationships with vendor account teams. Support development of operational standard operating procedures (SOP), policy, brochures, training materials and curriculum. Assist and support contract proposals, negotiations, counter proposals, SLA development, contract modifications and amendments. Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with goals. Support audit and compliance activities. Increase program value by implementing new programs to increase the value of our services. This includes planning, implementation, data analysis, communications, and outcome management. Review trends and industry information to determine best practices, operational efficiencies, or process improvements to enhance program performance and the member experience.

Requirements

Bachelor's Degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience
4+ Years experience within a business environment services delivery setting
Experience in project management
Experience in healthcare informatics
Project management skills for reporting multiple projects, involving multiple stakeholders, under tight deadlines
Advanced organizational skills with the ability to develop approaches that meet required objectives
Excellent communication (written and oral) and interpersonal skills with an ability to communicate to small and/or large audiences (both internal and external to BCBSA)
Technical proficiency with information technologies (e.g. Microsoft software applications)
Interpersonal skills with the ability to work with all levels of the Association, Plans, government and vendors
Ability to manage stakeholders and reconcile and integrate competing interests
Minimum of four years of experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics
Experience in project management and/or account management
Experience setting priorities and meeting objectives for projects with multiple stakeholders
Experience with Microsoft Office, Teams and SharePoint

Responsibilities

Supports vendor relationship, daily operations, and delivery of member benefits.
Collects, maintains, and resolves issues.
Shares program operational and performance data.
Supports timely resolution of inquiries, communication development, process documentation, reporting, implementation, compliance, and audit activities.
Ensures timely resolution of member inquiries from various sources.
Identifies and communicates performance and compliance risks to leadership.
Reviews regular reports to address issues.
Manages communication requests and system updates in compliance with applicable standards.
Supports and interacts with stakeholders to resolve inquiries.
Fosters collaborative relationships with vendor account teams.
Supports development of operational standard operating procedures (SOP), policy, brochures, training materials and curriculum.
Assists and supports contract proposals, negotiations, counter proposals, SLA development, contract modifications and amendments.
Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with goals.
Supports audit and compliance activities.
Increases program value by implementing new programs to increase the value of our services.
Plans, implements, analyzes data, manages communications, and manages outcomes for new programs.
Reviews trends and industry information to determine best practices, operational efficiencies, or process improvements to enhance program performance and the member experience.