Lead Total Cost of Care Implementation Manager

Blue Cross & Blue Shield of Rhode Island•Providence, RI

2d•$102,300 - $163,700•Hybrid

About The Position

The TCoC Program Implementation Manager is responsible for owning and managing the onboarding lifecycle of population health vendors. Assigned vendors will include varying degrees of complexity in areas such as eligibility, engagement, file exchanges, contracting and financial arrangements, member/client communications, billing, and training of member-facing teams. This includes but is not limited to the activities of multiple on-going implementations, daily vendor interaction and communication, timeline and critical task management, coordination across multiple resources and stakeholders working closely with the Enterprise Project Management Office (EPMO). Accountabilities also include the timely resolution of vendor related issues as they arise.

Requirements

Bachelor’s degree in business or related field, or an equivalent combination of education and experience
Three to five years previous operational experience
Established track record of vendor or client implementations
Project management methodologies, processes, and tools.
Knowledge of Project Development Life Cycle
Ability to lead and manage projects
Facilitate meetings and teamwork
Demonstrate leadership and problem-solving skills
Ability to think creatively and drive innovation
Establish and maintain strong working relationships with various stakeholders including team members, EPMO and IT resources, resources in other areas of the business and upper management
Ability to persuade, negotiate or influence internal and external stakeholders to build consensus
Ability to manage multiple priorities and resources in a dynamic environment across various departments, sites, and organize complex information
Proven ability to communicate, translate and execute effectively across multiple groups
Detail oriented with excellent follow through skills
Positive, energetic attitude, with the ability to handle sensitive and pressured situations
Able to work comfortably in a hands-on, multi-task, deadline-driven environment
Strong listening, verbal (especially telephone) and written communication skills are a must
Ability to effectively communicate with internal and external customers with a comfort level delivering presentations and meeting facilitation.
Proficiency with Microsoft products, i.e., Excel, PPT, Word, Project, etc.

Nice To Haves

Previous vendor implementation and management experience
Project Management certification (PMP)

Responsibilities

Responsible for effective execution of vendor implementations and contract renewals with timely project completion, issue identification/resolution, and delivery per contractual terms.
Serve as Business Lead for the EPMO.
Facilitate identification of business requirements relative to eligibility, engagement, claims sharing, vendor and client billing, communication, member and client facing messaging and risk revenue capture.
Utilize standardized New Program Implementation Worksheet to provide a consolidated source of truth for program details.
Develop deep understanding of required data transfers for each vendor and work closely with the TCoC Lead Data Analyst to ensure initial data transfers meet all requirements and are balanced to internal data sources.
Review and approve detailed data flows provided by the Lead Data Analyst.
Identify and implement processes to improve data accuracy including upfront data validation and automated error reporting.
Foster relationships with key personnel within vendors and internal teams/EPMO and participate in implementation meetings on a regular basis.
Serve as main point of contact for the vendor during the implementation.
Fully document vendor implementations in standardized Operational User Guide and Playbook.
Fully prepare Vendor Transition documents to provide a detailed reference for the Clinical Programs Operations Manager for ongoing program management post implementation.
Facilitate meetings with task groups or functional areas as required.
Proactively engage other members of the organization with specific subject knowledge to resolve issues.
Lead post implementation review of implementations to provide lessons learned and continuous improvement.
Modify and document processes as necessary.