Job Information
BlueCross BlueShield of North Carolina Project/Program Manager - Commercial Quality Improvement in Remote, North Carolina
Job Description
Manage small programs or a phase of a larger program. Provide full program management including needs analysis, program maintenance, administration and monitoring, data analysis, program evaluation, and vendor/contract administration if applicable. May also make recommendations for changes or modifications for assigned program and implement as needed.
What You'll Do
Manage/administer smaller programs or a phase of a larger program to ensure that prescribed activities are carried out in accordance with program objectives.
Assess needs and coordinate resources to enhance existing programs.
Monitor the progress of program components to ensure the overall goals, schedules, and benefits of the program will be met.
Document and present program results through operational reports, outcomes studies, presentations and publications. Prepare program reports for superiors.
Drafting program descriptions and evaluations and drafting ad hoc reports and documentation.
Recommend and/or implement program and process changes as needed to achieve program goals and objectives.
May have budget responsibilities to control expenditures in accordance with budget allocations, together with the conformance to timing, limits and usage of funding as agreed upon in the spending plan for the assigned program.
Monitor monthly HEDIS measure performance with rate tracking and reporting for multiple lines of business.
Perform deep dive analysis on current measure performance.
Coordinate and facilitate meetings as needed.
Collaborate with plan partners to help achieve aligned measure performance and CAHPS goals.
May handle vendor management and administer program contracts to ensure vendors meet service level agreements if applicable.
Must be proficient with Microsoft Excel, Teams, PowerPoint and Word.
What You'll Bring (Hiring Requirements)
Bachelor's degree or advanced degree (where required)
3+ years of experience in related field
In lieu of degree, 5+ years of experience in related field
Nice to Have
Health Plan/Insurance experience
Strong writing skills
Previous HEDIS measurement experience
Salary Range
$61,900.00 - $99,000.00
About Us
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.
Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.
Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.
Authorization to Work in the United States
We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.
For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:
Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming
Much more than a paycheck
The total value of working at Blue Cross NC goes far beyond your paycheck. We offer benefits and perks (https://careers.bluecrossnc.com/global/en/benefits) that help you thrive, such as competitive health benefits, bonus plans based on performance, 401(k) with employer match, paid time off (plus two well-being days), and a variety of career development and wellness programs.