Manager-UM Program Management

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.&nbsp;<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />For Application Timeline &amp; Selection Process:&nbsp;<a href="https://s3.amazonaws.com/data.vizirecruiter.com/Images/BCBSMCareers+-+Quick+Reference+Guide.pdf" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="https://ejko.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_3/requisitions" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

keywords: position summary,management,quality assurance,solutions,leadership,degree,experience,skills,department requirements,teamwork,build,leadership,support

Full-Time

Competitive Total Compensation Package

Overview: Responsible for planning, organizing and managing an assigned business unit. Operate within broad objectives to ensure optimum utilization of resources; adapt business unit plans and priorities to address resource and operational challenges. Evaluate policies, procedures and business unit goals to make decisions and solve problems.
Responsibilities: <ul> <li>Manage activities of a department including, but not limited to planning, problem-solving, staff development, and communication.</li> <li>Manage the evaluation of new and existing business processes to identify areas of opportunity and execute on business unit objectives, supporting continuous improvement.</li> <li>Lead, direct, evaluate and develop the work of assigned employees.</li> <li>Responsible for special projects, programs, and initiatives to ensure successful delivery of business outcomes.</li> <li>Provide effective and efficient solutions to complex business problems</li> <li>Ensure that day-to-day business unit operations align with organizational objectives.</li> </ul>
Requirements: <ul> <li>Bachelor's Degree in a related field is required.&nbsp; Master's Degree in a related field is preferred.&nbsp;</li> <li>Five (5) years of experience in a related field is required.</li> <li>Previous experience leading projects and/or teams is required.</li> <li>Ability to effectively lead, coach and develop team members.</li> <li>Ability to work effectively in a team environment.</li> <li>Strong organizational, planning, analytical, and problem-solving skills.</li> <li>Working knowledge of corporate organizational structures, including functional responsibilities.</li> <li>Strong verbal, written communication and interpersonal skills.</li> <li>Ability to manage multiple priorities concurrently.</li> <li>Ability to solve practical problems and deal with moving variables in situations with limited standardization and alignment.</li> <li>Ability to interface and present to all levels of the organization.&nbsp;&nbsp;</li> <li>Ability to build relationships and work collaboratively with cross-functional teams.</li> </ul> <br /><strong><strong>Department Requirements:<br /></strong></strong> <ul> <li>Experience and knowledge in gold carding criteria and guideline implementation based on clinical insight</li> <li>Ability to work with IT, vendor, providers and other functions on ad hoc inquiries</li> <li>Ability to run Cave&nbsp;Marketbasket&nbsp;system</li> <li>Ability to manage Cave software, which will require six distinct data runs on a quarterly basis, identified below:</li> <li>Support IT in the creation of input files (grouping of Practice Units, mapping of specialties, mapping of BETOS codes, etc.)</li> <li>Validate parameters for running Cave software</li> <li>Validate system outputs</li> </ul>