We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
You should know that:
- Jobs are updated and posted daily.
- You must submit your resume online.
- Apply for each position for which you are qualified and interested in.
- You will only be considered for positions for which you apply.
- Resumes are only accepted for posted positions.
- Positions are full-time unless otherwise stated.
- Due to the high volume of applicants, only those most qualified will be contacted.
- We are unable to accept phone calls.
POSITION PURPOSE :
Responsible for developing and leading a cross functional matrixed team comprised of various functions within the company such as actuarial, marketing services, clinical solutions, payment innovations, network management, benefit operations data analytics, product development and marketing to mitigate risks, improve operations and implement initiatives to ensure mutual goals are met for the overall Ochsner Health Network relationship.
Serves as the primary point of contact and liaison between OHN executive leadership and BCBSLA for all strategic and operational initiatives.
NATURE AND SCOPE :
This position reports to the VP, Provider Relations & Contracting.
Activities of Direct Reports:
This position does not have direct reports.
Necessary Contacts :
In order to effectively fulfill this position, the incumbent must be in contact with the following:
All levels of internal staff in the Reimbursement, Value Transformation, Sales and Marketing, Healthcare Analytics, Enterprise Data Management, Information Technology and other BCBCLA departments as well as all levels of Ochsner staff; including executive management in both organizations.
QUALIFICATIONS :
Bachelor’s Degree in Business, Finance, Accounting, Statistics, Health Care Administration, Project Management or healthcare related field is required. Four years of related work experience can be used in lieu of a degree. Graduate work or a master’s degree is preferred.
Must have 7 years of experience in payor and/or provider operations, strategy, data management or analytics, value-based care and/or project management.
Strong analytical, organizational and problem-solving skills are required.
Strong communication, interpersonal, collaboration and presentation skills with the ability to facilitate meetings in a professional and constructive manner.
Must be able to influence all levels of internal multi-divisional BCBSLA staff as well as the correct Ochsner stakeholders to mitigate risk and achieve satisfactory results.
Requires knowledge of Payor or Provider reimbursement, both fee for service (FFS) and value based reimbursement, data management/analytics, provider and/or payor operations.
Proficiency with Microsoft Office software along with advanced level Excel and/or Access experience is required.
Must be able to manage multiple complex programs and initiatives to meet established goals.
Knowledgeable in project management approaches, tools and phases of the project lifecycle is required to ensure initiatives are being managed and communicated effectively and efficiently to the correct stakeholders in both organizations.
ACCOUNTABILITIES & ESSENTIAL FUNCTIONS :
Accountable for maintaining strong working relationships with internal BCBSLA stakeholders that work with Ochsner regularly.
Accountable for maintaining strong working relationships with Ochsner stakeholders that work with Ochsner regularly.
Accountable for participating, communicating, and documenting status on all major initiatives from a project management and risk management perspective as well as guiding initiatives to execution or closure.
Accountable for working with BCBSLA and Ochsner stakeholders to mitigate risk on projects/initiatives important to both organizations, including escalations to senior management to drive resolution.
Accountable for tracking and mitigating risk on the following types of initiatives with Ochsner: 1) Reimbursement contracts; 2) Value based contracts; 3) Data exchange; 4) Blue Connect/Product related initiatives; 5) Care Delivery Transformation related initiatives and 6) Digital and telehealth 6) Ochsner Employee Health Plan and related issues.
Responsible for facilitating sessions with key BCBSLA stakeholders to keep everyone abreast of all initiatives and discussing strategies/tactics to mitigate risks and keep initiatives on track.
Responsible for understanding the context, goals, and time frames for all of the initiatives that this role will be responsible for tracking/monitoring and keeping on track.
Responsible for ensuring that the right stakeholders from BCBSLA and Ochsner are involved in the right initiatives/calls/meetings to ensure optimal communications between the two organizations.
Responsible for identifying and preventing duplicative and/or conflicting work across different initiatives.
Leads and facilitates a monthly internal meeting with BCBSLA stakeholders to communicate progress/risks/issues across all key initiatives with the goal or raising issues/risks to be owned and mitigated by the appropriate BCBSLA stakeholder(s).
Responsible for tracking and following up with BCBSLA and Ochsner stakeholders to ensure that actions that come out of meetings between Ochsner and BCBSLA including JOC meetings, data exchange meetings, product meetings and reimbursement related meetings.
The physical demands described here are representative of those that must be met by an employee to successfully perform the accountabilities (essential functions) of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.
Job Duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while sitting or standing.
The ability to comprehend, document, and analyze are required.
Collaborates
Building partnerships and working collaboratively with others to meet shared objectives.
- Shares information with others so there are no surprises.
- Involves others as appropriate to accomplish individual and group
goals.
- Encourages unity rather than “us vs. them” thinking.
- Welcomes and acknowledges the ideas and input of others.
Customer focus
Building strong customer relationships and delivering customer-centric solutions.
- Searches for ways to improve customer service.
- Follows up with customers to ensure problems are solved.
- Independently anticipates and meets customer needs.
- Internalizes customer feedback and provides innovative ideas to
meet their future needs.
Ensures accountability
Holding self and others accountable to meet commitments.
- Monitors progress of performance and changes approach
accordingly.
- Takes ownership of own work.
- Takes responsibility for successes and failures in own work.
- Follows through on commitments.
Instills trust
Gaining the confidence and trust of others through honesty, integrity, and authenticity.
- Is honest and straightforward when working with others.
- Honors agreements and commitments, even when working
through competing priorities.
- Shows consistency between words and actions.
- Maintains integrity and professional codes of conduct.
Values differences
Recognizing the value that different perspectives and cultures bring to an organization.
- Behaves with sensitivity toward differences in cultural norms,
expectations, and ways of communicating.
- Challenges stereotyping or offensive comments.
- Seeks out the diverse perspectives and talents of others.
- Works effectively with others who have different perspectives,
backgrounds, and/or styles.
Plans and aligns
Planning and prioritizing work to meet commitments aligned with organizational goals.
- Aligns own work plans and priorities with those of other units.
- Balances the need for adequate planning with the need for action.
- Creates a realistic time line with steps outlined in the right
sequence.
- Anticipates and minimizes bottlenecks or delays.
Manages complexity
Making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
- Assesses complex issues from multiple angles in order to get the
complete picture.
- Evaluates the potential consequences and implications of different
options.
- Identifies the underlying issues and root causes of problems.
- Incorporates new information and concepts when solving prob-
lems.
Persuades
Using compelling arguments to gain the support and commitment of others.
- Negotiates effectively for needed resources.
- Makes appropriate compromises to arrive at solutions with others.
- Provides sound rationale for recommendations to gain others’ sup
port and commitment.
- Convinces others to support his/her positions or recommenda-
tions.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
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