Sr. Mgr, Mandate Implementation

Horizon Healthcare Services•Newark, NJ

About The Position

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. This position is responsible for assessing and identifying the best enterprise-wide solutions for all legislative and regulatory mandates for the company. Reporting to the Director of the Mandate Program Office (MPO), EOB Governance, UAT CoE, BCBS Association Programs and GP Vendor Systems Management, this individual directs the planning and execution of all mandate projects through cross-divisional collaboration. Establishes Mandate Governance processes and ensures reporting to EVP Steering Committee. Ensures that all mandate projects provide an end-to-end solution that is optimized to leverage Horizon’s existing operations and systems. Implements federal, state and BCBSA mandates. Provides enterprise-wide oversight to ensure that Mandate portfolio is planned and implemented in accordance with standard corporate processes ensuring that senior management is made aware of any potential adverse impact upon other enterprise-funded, discretionary projects or ongoing operations.

Requirements

High School Diploma/GED required
Requires a minimum of 5+ years of management experience.
Requires 5+ years project management experience with working understanding of PMO structures and capabilities
Requires experience in Healthcare with legal and regulatory compliance background
Ability to interact and influence senior leaders of the organization
Excellent supervisory/management skills
Strong analytical and problem solving
Superb conflict management and relationship management skills
Excellent technical proficiency in project management tools
Excellent facilitation, coaching and platform skills
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Nice To Haves

Bachelor degree preferred or relevant experience in lieu of degree
PMI Certification desired

Responsibilities

Lead efforts to collaborate with cross-enterprise leaders to proactively identify pending federal and state legislation/regulation and provide senior management with a comprehensive assessment of impact to existing business and strategy, identify and direct projects to implement new laws and regulations.
Ensure Mandate group partners with Legal, Compliance and business owners of individual projects within program to balance project scope, benefits, budget, and resource allocations to meet overall program goals and objectives.
Directs program manager(s) to: (1) meet annual program objectives of mandate compliance; (2) ensure overall client satisfaction and appropriate level of service delivery and project deliverables; and, (3) ensure a seamless transition of project deliverables to ongoing operations.
Directs communication and reporting of key program management information including assessments of key risks and issues to EPMO and Senior Leadership Team. Also leads annual mandate portfolio planning process in conjunction with business, EPMO and IT leaders, including justified request for enterprise funding.
Conducts performance reviews on an annual basis for assigned staff and responsible for hiring, promotions, performance reviews and administering salaries for assigned staff; Ensures assigned staff meets all regulatory requirements and comprehends and complies with best practices, professional standards, internal policies, and procedures
Accountable for maintaining effective internal controls over the processes and transactions under areas of responsibility including the completeness and accuracy of financial information and transactions, compliance with applicable laws and regulations, and the effectiveness and efficiency of operations.