Principal Business Operations Advisor
About The Position
Healthy Blue Care Together (HBCT) is partnering with the North Carolina Department of Health and Human Services to operationalize the Children and Families Specialty Plan (CFSP). CFSP is a single, statewide Medicaid Plan designed to provide seamless, integrated, and coordinated care to enrolled infants, children, youth, young adults, and families served and previously served by the child welfare system. HBCT is outcomes-driven and focused on ensuring that all members have access to quality services and benefits across North Carolina, addressing their physical health, behavioral health, pharmacy, intellectual/developmental, long-term services and supports, unmet health-related resource, and care management needs. The Principal Business Operations Advisor (OA), in collaboration with Plan-level leadership and support staff, will oversee monitoring and evaluation of key aspects of HBCT Plan execution, focusing on: Plan-based and delegated staffing and performance; clinical, care management, medication monitoring, psychosocial, and specialty program implementation; and provider network and service access equity and quality. The OA will lead the development of data management and reporting strategies aligned with our Continuous Quality Improvement framework and Monitoring and Evaluation plan. The OA will collaborate with the Outcomes Monitoring and Evaluation Team to support population- and member-level outcomes monitoring and evaluation.
Requirements
- Bachelor's degree or advanced degree (where required)
- 8+ years of experience in related field.
- In lieu of degree, 10+ years of experience in related field.
Nice To Haves
- Continuous quality improvement experience within a Managed Care Organization
- Experience with Child Welfare systems, data analytics, KPIs, and metrics
- Expert in excel, tableau and/or other data management tools
- Experience in working in a matrixed environment, facilitating work across multiple teams and priorities
Responsibilities
- Develop and implement Continuous Quality Improvement framework and Monitoring and Evaluation plan.
- Build and facilitate repeatable and Plan-focused strategic planning processes that include confirmation of continued relevance, progress evaluation and communication to affected stakeholders.
- Advise and communicate with Plan leadership and external stakeholders, including senior leadership, regarding programs, projects, initiatives, emerging issues and challenges within the child welfare systems.
- Develop and use key improvement metrics, such as dashboards, team reporting, regulatory reports and scorecards to review program data and results in comparison with benchmark metrics and expected outcomes.
- Monitor and evaluate delegated staff functions activities for compliance and effectiveness.
- Proposes a variety of solutions to business issues/problems utilizing appropriate analysis tools (ie Cost/Benefit Analysis, Flowcharting, etc).
- Lead the development of a Monitoring and Evaluation Plan, focused on Plan execution and achievement of objectives and goals.
- Lead the coordination, planning, and facilitation of various Plan-level monitoring and evaluation workgroups to make them more effective, data-driven, and outcomes based.
- Lead monitoring and evaluation strategy development and activities addressing staffing, staff to member rations, and staff performance
- Support development of business plans and analysis under guidance from Plan leadership.
- Facilitate the adoption of CQI-driven Plan operating procedures and processes for the Plan and assist with the communication to and education of external stakeholders and delegated partners.
- Provide input and recommended strategy for Plan leadership’s public speaking engagements and/or Board or committee meetings.
- Facilitate change management work to support business and process improvements and overall Plan effectiveness.
- Lead and coordinate work for special projects or initiatives for the Plan as assigned.
- Possible duties could include: Evaluation of potential opportunities and recommendations to reduce costs/improve efficiencies Review and evaluation of best or next practice opportunities for potential adoption Develop recommendations based on important industry literature and ensure leadership is briefed on current and emerging issues of importance to the organization.
- Serve as lead on engagements with external entities (i.e. consultants, external stakeholders, delegated partners) and coordinate data gathering and research efforts based on the direction of Plan leadership.
- Manage tracking of initiatives/projects for the division and independently create presentations of initiative/project progress for varied audiences, which may include Senior Plan Leadership.
- Lead the consolidation and standardization of data analysis and reporting for relevant Plan operations.
- Provide analysis and insights for proposed strategic initiatives by leveraging a unique perspective on the end-to-end operations of the Plan.
- Support Plan budget analysis, provide input into and monitor budget forecasts, and review progress against administrative cost reduction goals
- Track and evaluate goal progress, including data collection and analysis of key performance metrics (KPIs).
Benefits
- The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
- Work-life balance, flexibility, and the autonomy to do great work
- Medical, dental, and vision coverage along with numerous health and wellness programs
- Parental leave and support plus adoption and surrogacy assistance
- Career development programs and tuition reimbursement for continued education
- 401k match including an annual company contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
