FEP Operations Program Specialist

Posted 7 Days Ago
Be an Early Applicant
Northwest, DC, USA
In-Office
74K-97K Annually
Mid level
Insurance
The Role
Support vendor relationships and daily program operations for member benefits. Manage inquiries, reporting, compliance, SOP and training development, contract/SLA support, implementation projects, data analysis, and continuous process improvements to enhance program performance and member experience.
Summary Generated by Built In
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.

The posting range for this position is:

73,654.77 - 97,263.19

Qualifications:
Education

  • Required Bachelor's Degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience

Experience

  • Required 4+ Years experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics

Knowledge Skills and Abilities

  • 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

Extra Posting Information:

  • 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

#LI-Hybrid

The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this postingWe may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay. 

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees. 

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. 

 

Skills Required

  • Bachelor's degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience
  • 4+ years experience in a business environment services delivery setting with project management and/or healthcare informatics
  • Project management skills for managing multiple projects and stakeholders under tight deadlines
  • Advanced organizational skills with ability to develop approaches that meet objectives
  • Excellent written and oral communication and interpersonal skills for internal and external audiences
  • Technical proficiency with information technologies, specifically Microsoft Office, Teams, and SharePoint
  • Experience developing operational SOPs, policies, training materials, and curriculum
  • Experience supporting contract proposals, negotiations, SLAs, contract modifications and amendments
  • Experience with reporting, data analysis, compliance, audit activities, and continuous process improvement
  • Ability to manage stakeholders and reconcile competing interests
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The Company
HQ: Chicago, IL
3,161 Employees
Year Founded: 1910

What We Do

Blue Cross Blue Shield Association is a national federation of 34 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Index.

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